肠内营养联合微生态制剂对重症胰腺炎患者的疗效

Effect of enteral nutrition combined with microecological preparation on patients with severe acute pancreatitis

目的观察肠内营养联合微生态制剂对重症胰腺炎患者细菌移位、免疫功能、炎症反应的影响。方法选择我院2017年1月至2019年7月收治的200例重症胰腺炎患者为研究对象,根据治疗方法不同分为A组、B组、C组。A组患者采用肠外营养治疗,B组患者采用肠内营养治疗,C组患者采用肠内营养联合微生态制剂治疗。比较3组患者的治疗效果,治疗后细菌移位情况、细胞免疫功能及炎症因子水平。结果C组患者总有效率高于A组和B组(χ^(2)=5.423、9.629,P=0.020、0.002),A组和B组总有效率差异无统计学意义(χ^(2)=0.790,P=0.374)。治疗后,C组患者血清内毒素、D-乳酸水平低于A组和B组,同时B组低于A组(均P<0.05)。治疗后,C组患者CD3^(+)细胞、CD4^(+)细胞、CD4^(+)/CD8^(+)水平高于A组和B组,同时B组高于A组(均P<0.05)。C组患者CD8^(+)细胞水平低于A组和B组,同时B组低于A组(均P<0.05)。治疗后,C组患者血清IL-6、IL-8、TNF-α水平低于A组和B组,同时B组低于A组(均P<0.05)。结论肠内营养联合微生态制剂可改善重症胰腺炎患者细菌移位情况和免疫功能,减轻患者炎症因子水平。

Objective To observe the effects of enteral nutrition combined with microecological preparations on bacterial translocation,immune function and inflammatory response in patients with severe acute pancreatitis.Methods A total of 200 patients with severe pancreatitis who treated in our hospital from Jan 2017 to Jul 2019 were divided into group A,group B and group C according to different treatment methods.Group A was treated with parenteral nutrition,group B was treated with enteral nutrition,and group C was treated with enteral nutrition combined with microecological preparation.The therapeutic effects,bacterial translocation after treatment,cellular immune function and inflammatory factor levels of the three groups were compared.Results The total effective rate of group C was higher than that of group B and group A(χ^(2)=5.423,9.629;P=0.020,0.002).There was no significant difference in the total effective rate between group A and group B(χ^(2)=0.790,P=0.374).After treatment,the levels of endotoxin and D-lactic acid in group C was lower than that in group A and group B(all P<0.05),simultaneously group B was lower than group A.After treatment,the levels of CD3^(+)cell,CD4^(+)cell,CD4^(+)/CD8^(+)in group C were higher than group A and group B,simultaneously group B was higher than group A.CD8^(+)level in group C was lower than group A and group B(all P<0.05),simultaneously group B was lower than group A.After treatment,the levels of serum IL-6,IL-8 and TNF-αin group C were lower than those in group A and group B(all P<0.05),and simultaneously group B was lower than group A(all P<0.05).Conclusion Enteral nutrition combined with microecological preparation can improve bacterial translocation and immune function in patients with severe pancreatitis and reduce the content of inflammatory factors.