超早期肠内营养与微生态制剂联合治疗重症急性胰腺炎患者的效果观察

Effect of ultra-early enteral nutrition combined with microecological preparations on severe acute pancreatitis

目的观察超早期肠内营养与微生态制剂联合治疗重症急性胰腺炎的效果.方法选取我院2017年12月至2019年11月收治的重症急性胰腺炎患者96例,根据随机数字表法分为延迟肠内营养组(48例)和超早期肠内营养组(48例),延迟肠内营养组接受微生态制剂联合延迟肠内营治疗,对照组接受微生态制剂联合超早期肠内营养治疗.观察2组患者治疗后血清总蛋白、C-反应蛋白、白蛋白、淀粉酶水平、急性生理及慢性健康状况评分(APACHEⅡ)及安全性.结果2组治疗前血尿淀粉酶差异无统计学意义(P>0.05).治疗后,超早期肠内营养组血尿淀粉酶恢复正常时间及住院时间均短于延迟肠内营养组,差异均具有统计学意义(P<0.05).2组恶性呕吐、乏力、皮疹等不良反应发生率方面的差异无统计学意义(P<0.05).2组患者治疗前APACHEⅡ评分差异无统计学意义(P>0.05).治疗后1周,超早期肠内营养组APACHEⅡ评分较延迟肠内营养组降低,差异均具有统计学意义(P<0.05).超早期肠内营养组患者治疗1周后血清总蛋白较延迟肠内营养组高,C-反应蛋白较延迟肠内营养组低,差异均具有统计学意义(P<0.05).结论超早期肠内营养与微生态制剂联合在重症胰腺炎中取得良好效果,可改善患者营养水平,促进恢复,降低炎症反应及血尿淀粉酶.

Objective To observe the effect of the combination of ultra-early enteral nutrition and microecological preparations on severe acute pancreatitis.Methods A total of 96 patients with severe acute pancreatitis treated in our hospital from December 2017 to November 2019 were selected and divided into delayed enteral nutrition group(48 cases)and ultra-early enteral nutrition group(48 cases)according to the random number table method.The delayed enteral nutrition group received microecological preparations combined with delayed enteral nutrition treatment,and the control group received microecological preparations combined with ultra-early enteral nutrition treatment.The serum total protein,C-reactive protein,albumin,amylase levels,APACHEⅡscore and safety of the two groups of patients were observed.Results There was no significant difference in hematuria amylase before treatment between the two groups(P>0.05).After treatment,the time to return to normal hematuria amylase and hospital stay in the ultra-early enteral nutrition group were shorter than those in the delayed enteral nutrition group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions such as malignant vomiting,fatigue,and rash between the two groups(P<0.05).There was no significant difference in APACHEⅡscore between the two groups of patients before treatment(P>0.05).One week after treatment,the APACHEⅡscore of the ultra-early enteral nutrition group was lower than that of the delayed enteral nutrition group,and the dif-ferences were statistically significant(P<0.05).After 1 week of treatment in patients with ultra-early enteral nutrition,the total serum protein was higher than that in the delayed enteral nutrition group,and the C-reactive protein was lower than that in the delayed enteral nutrition group.Conclusion The combination of ultra-early enteral nutrition and microecological preparations has achieved good results in severe pancreatitis,which can improve the nutritional level of patients,promote recovery,and reduce inflammatory response and hematuria amylase.