早期肠内营养加入微生态制剂对重症急性胰腺炎患者肠黏膜功能和炎症反应的影响

Effect of microecological preparation added in early enteral nutrition on intestinal mucosal function and inflammatory response in patients with severe acute pancreatitis

目的探讨早期肠内营养加入微生态制剂对重症急性胰腺炎患者肠黏膜功能和炎症反应的影响。方法选取80例急性重症胰腺炎患者,按照随机数字表法分为观察组40例和对照组40例。对照组采用早期肠内营养治疗,观察组在早期肠内营养中加入微生态制剂,比较两组临床疗效、肠黏膜功能及炎性因子水平。结果两组总有效率比较,差异无统计学意义(χ^2=2.22,P>0.05);观察组患者的腹胀消失时间、腹痛消失时间、排气功能恢复时间均明显短于对照组(t分别=4.34、2.53、3.46,P均<0.05);两组治疗后内毒素、D-乳酸、白细胞介素(IL)-6、IL-10、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平较治疗前明显降低(t分别=19.77、17.18、14.14、8.49、20.28、14.89、22.21、16.04、17.67、14.91、17.30、13.65,P均<0.05),且观察组治疗后这些指标明显低于对照组(t分别=5.31、6.32、5.84、6.36、7.01、5.76,P均<0.05)。结论早期肠内营养加入微生态制剂能够改善重症急性胰腺炎患者临床症状,恢复肠黏膜屏障功能,减轻炎症反应。

Objective To investigate the effects of microecological preparation added in early enteral nutrition on intestinal mucosal function and inflammatory response in patients with severe acute pancreatitis. Methods A total of 80 patients with acute severe pancreatitis were selected as subjects and randomly divided into the observation group and control group with 40 cases in each.The control group was treated with early enteral nutrition,the observation group was received microecological preparations added in early enteral nutrition.The clinical efficacy,intestinal mucosal function and inflammatory factor levels were compared between the two groups. Results There was no significant difference in the total effective rate between the two groups(χ^2=2.22,P>0.05).The disappearance time of abdominal distension and abdominal pain,the recovery time of exhaust function in the observation group were significantly shorter than those in the control group(t=4.34,2.53,3.46,P<0.05).After treatment,the levels of endotoxin,D-lactic acid,interleukin(IL)-6,IL-10,C-reactive protein(CRP),and tumor necrosis factor alpha(TNF-α)in two groups were significantly lower than those before treatment(t=19.77,17.18,14.14,8.49,20.28,14.89,22.21,16.04,17.67,14.91,17.30,13.65,P<0.05),and these parameters in observation group after treatment was significantly lower than those in control group(t=5.31,6.32,5.84,6.36,7.01,5.76,P<0.05). Conclusion The microecological preparation added in early enteral nutrition can improve the clinical symptoms of patients with severe acute pancreatitis,restore intestinal mucosal barrier function,and reduce inflammation.