不同时机肠内营养对重症急性胰腺炎患者炎性因子与免疫功能的影响

Effects of enteral nutrition on inflammatory factors and immune function at different opportunities in patients with severe acute pancreatitis

目的分析不同时机肠内营养对重症急性胰腺炎患者炎性因子与免疫功能的影响。方法选取收治的100例重症胰腺炎患者,按照随机数字表法分为观察组和对照组,每组50例。对照组采用延迟肠内营养治疗,观察组采用早期肠内营养治疗,观察2组患者一般情况(包括性别、年龄、并发症、病因)、C-反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、恢复情况(包括腹痛消失时间、腹胀消失时间、肠鸣音恢复时间、排气排便恢复时间、住院时间)。结果 2组患者CRP比较差异有统计学意义(P<0.05)。随着治疗的进行,2组患者CRP水平均有所下降,但观察组患者下降程度明显大于对照组(P<0.05);2组患者PCT比较差异有统计学意义(P<0.05)。2组患者PCT水平均下降,但观察组患者下降程度明显大于对照组(P<0.05);2组患者治疗前后TNF-α含量比较差异有统计学意义(P<0.05),2组患者TNF-α含量降低,但观察组患者降低程度明显大于对照组(P<0.05);2组患者治疗前后IL-6含量比较差异有统计学意义(P<0.05),2组患者IL-6含量降低,但观察组患者降低程度明显大于对照组(P<0.05);观察组患者腹痛消失时间、腹胀消失时间、肠鸣音恢复时间、排气排便恢复时间、住院时间均明显低于对照组(P<0.05)。结论早期肠内营养能有效改善重症急性胰腺炎患者炎症、免疫反应,促进患者术后恢复,值得临床推广。

Objective To investigate and analyze the effects of enteral nutrition on inflammatory factors and immune function in patients with severe acute pancreatitis at different opportunities. Methods A total of 100 patients with severe acute pancreatitis who were treated in our hospital were enrolled in the study. According to random digital table,these patients were divided into observation group（ n = 50） and control group（ n = 50）. The patients in control group were treated by delayed enteral nutrition,however,the patients in observation group were treated by early enteral nutrition. The general status including gender,age,etiology and complications,CRP（ C reactive protein）,PCT（ procalcitonin）,TNF-α（ tumor necrosis factor-α）,IL-6 and recovery conditions including disappearing time of abdominal pain and abdominal distension,recovery time of bowel sound,exhaust and defecation,hospitalization time were observed and compared between two groups. Results However there was significant difference in CRP between two groups（ P〈0. 05）. With the treatment going on,the CRP levels were decreased in both groups,moreover,the decrease degree in observation group was more obvious than that in control group（ P〈0. 05）. The repeat analysis of variance showed that there was significant difference in PCT between two groups（ P〈0. 05）. the PCT levels were decreased in both groups,but the decrease degree in observation group was more obvious than that in control group（ P〈0. 05）. There were significant differences in levels of TNF-α before and after treatment between two groups（ P〈0. 05）,the levels of TNF-α were decreased in both groups,but the decrease degree in observation group was remarkably greater than that in control group（ P〈0. 05）. Moreover there were significant differences in IL-6 levels before and after treatment between two groups（ P〈0. 05）,the IL-6 levels were decreased in both groups,however,the decrease degree in observation group was significantly greater than that in control group（ P〈0. 05）. Besides the disappearing time of abdominal pain and abdominal distension,recovery time of bowel sound,exhaust and defecation,hospitalization time in observation group were significantly shorter than those in control group（ P〈0. 05）. Conclusion The early enteral nutrition can effectively improve the inflammatory and immune reactions in patients with severe acute pancreatitis,which can promote the postoperative recovery of patients,thus,which is worth uisng widely in clinical practice.