早期肠内营养对急性胰腺炎病人内外分泌功能和远期生活质量的影响

The effects of early eternal nutrition on pancreatic endocrine/exocrine functions and long-term quality of life in acute pancreatitis patients

目的:本研究旨在探究早期进行肠内营养(EN)能否改善AP病人远期内外分泌功能和生活质量。方法:回顾性观察性研究,回顾性分析2013年01月~2018年10月入住我院的成年胰腺炎病人的临床数据,经过纳排标准后,最终有26例病人纳入早期启动EN组,44例病人纳入晚期启动EN组。统计并分析病人的一般临床资料、院内临床预后指标以及远期内外分泌功能、生活质量情况。结果:在基线数据方面,两组之间没有显著差异,但早期启动EN组病人接受经皮穿刺引流比例高于对照组,接受手术干预比例低于对照组,但两组间没有统计学差异。在短期预后方面,早期启动EN可降低ICU内住院天数;在远期预后方面,早期启动EN可降低糖尿病等内分泌功能不全的发生概率,早期启动EN组病人胰酶制剂的需求降低,且SF-36生活质量评估量表评分显著高于对照组。结论:早期启动EN可改善AP病人远期预后,降低内外分泌功能不全的发生率,改善远期生活质量。

Objective:The aim of this study was to explore whether early enteral nutrition(EEN)could improve long-term clinical outcomes,mainly pancreatic endocrine and exocrine functions,as well as quality of life in acute pancreatitis(AP)patients.Methods:A retrospective review of AP patients admitted to our hospital from January 2013 to October 2018 was performed.After inclusion and exclusion,twenty-six patients were eventually included in the EEN group and 44 patients in the late EN group.The demographic characteristics,clinical outcomes,long-term endocrine and exocrine functions,as well as quality of life of study patients were recorded and analyzed.Results:In terms of baseline data,there was no significant difference between the two groups.More patients in the EEN group received percutaneous drainage and less patients underwent open surgery compared with patients in the late EN group,while there was no statistical difference between the two groups.As to in-hospital outcomes,early initiation of EN could reduce the length of ICU stay.In the long-term follow-up,EEN could reduce the incidence of endocrine dysfunction such as diabetes mellitus as well as the demand for pancreatic enzyme use.In addition,the SF-36 quality of life assessment score in the EEN group was significantly higher than that in the late EN group.Conclusion:Early initiation of EN could improve the long-term prognosis of AP patients,manifested as the reduced incidence of endocrine and exocrine dysfunction and the improved long-term quality of life.