肠内外营养支持治疗重症急性胰腺炎合并感染的临床效果

Clinical effectiveness of enteral and parenteral nutrition support for severe acute pancreatitis complicated with infection

目的探讨肠内外营养支持治疗重症急性胰腺炎合并感染的临床效果。方法选取2015年9月-2017年9月重庆市某医院收治的66例重症急性胰腺炎合并感染患者为研究对象。采用随机数字表法将患者分为观察组与对照组,每组33例。给予对照组患者肠外营养支持治疗;给予观察组患者肠内外营养支持治疗。比较治疗前及治疗7d时2组患者的感染指标[白细胞(WBC)及C反应蛋白(CRP)]、营养指标[白蛋白(ALB)、前蛋白(PA)及血红蛋白(Hb)]及免疫指标[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)及免疫球蛋白M(IgM)]。结果治疗前,2组患者WBC,CRP水平比较,差异无统计学意义(P>0.05)。治疗7d时,2组患者WBC,CRP水平均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者ALB,PA及Hb水平比较,差异无统计学意义(P>0.05)。2组患者治疗前及治疗7d时ALB,PA及Hb水平比较,差异无统计学意义(P>0.05)。治疗前,2组患者IgA,IgG及IgM水平比较,差异无统计学意义(P>0.05)。治疗7d时,2组患者IgG及IgM水平均高于治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05)。治疗7d时,观察组患者IgA水平高于治疗前,并高于对照组,差异均有统计学意义(P<0.05)。治疗前及治疗7d时对照组患者IgA水平比较,差异无统计学意义(P>0.05)。结论将肠内外营养支持治疗应用于重症急性胰腺炎合并感染患者的治疗中,临床效果显著,其可提高患者机体免疫力,有助于促进患者病情好转,值得临床推广应用。

Objective To assess the clinical effectiveness of enteral and parenteral nutrition support for severe a cute pancreatitis （SAP） complicated with infection. Methods A total of 66 patients with SAP and infection trea ted at a Chongqing hospital between September 2015 and September 2017 were included in this study. Based on a random number table~ patients were allocated to receive enteral and parenteral nutrition support （trial group, n= 33） or parenteral nutrition support alone （the control group, n=33）. Infection parameters （WBC and CRP） , nu trition parameters （AI.B, PA and Hb）, and immune parameters （lgA, lgG, and lgM） were measured before treatment and 7 days after treatment, which were compared between the two groups. Results The pre treatment WBC and CRP levels were similar between the two groups （P〉0.05）. After 7 days of treatment, the WBC and CRP levels were reduced in both groups, with greater reductions in the trial group （P〈0.05）. Both pre treat ment and post treatment AI.B, PA and Hb levels were comparable between the two groups （P〉0.05）. The pre treatment IgA, IgG, and IgM levels were similar between the two groups （P〉0.05）. After 7 days of treatment, the lgG and lgM levels were increased in both groups, with greater elevations in the trial group （P〈0.05）. The post-treatment lgA level in the trial group was increased as compared with its pre-treatment level as well as that in the control group （P〈0. 05）; while the lgA level in the control group remained unchanged before and after treatment （P〉0.05）. Conclusion Enteral and parenteral nutrition support has favorable efficacy for SAP corn plicated with infection, which may help to enhance immunity, promote clinical recovery,and deserve widespread clinical application.