肠内营养干预治疗重症急性胰腺炎的临床研究

Clinical Study on Enteral Nutrition Therapy in the Treatment of Severe Acute Pancreatitis

目的:探究肠内营养治疗技术应用于重症急性胰腺炎(SAP)患者的临床效果。方法:选取2017年6月至2019年11月驻马店市中心医院收治的SAP患者60例,按随机数字表法将其分为对照组和观察组,各30例。对照组给予完全肠外营养支持治疗,观察组给予肠内营养支持治疗,治疗时间为1个月。观察两组患者的炎症因子水平、急性生理与慢性健康评分Ⅱ(APACHEⅡ)及营养指标。结果:与治疗前比,治疗后两组患者血清白细胞介素–6(IL–6)、肿瘤坏死因子–α(TNF–α)、C反应蛋白(CRP)水平下降,差异具有统计学意义(P<0.05),且观察组血清CRP水平低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组患者APACHEⅡ比较,差异无统计学意义(P>0.05);治疗后,观察组APACHEⅡ低于对照组,差异具有统计学意义(P<0.05)。与治疗前比,治疗后两组患者白蛋白(ALB)、血红蛋白(Hb)水平显著升高,血淀粉酶水平显著降低,差异均具有统计学意义(P<0.05);且观察组ALB水平高于对照组,差异具有统计学意义(P<0.05),观察组Hb、血淀粉酶水平与对照组比较,差异均无统计学意义(P>0.05)。结论:肠内营养治疗可以降低SAP患者炎症因子水平及APACHEⅡ,改善患者营养状态,有利于患者恢复。

Objective To explore the clinical effects of enteral nutrition therapy technology applied to patients with severe acute pancreatitis(SAP).Methods A total of 60 SAP patients admitted to Zhumadian Central Hospital from June 2017 to November 2019 were selected and divided into a control group and an observation group with 30 cases in each group,according to the random number table method.The control group was given complete parenteral nutrition support treatment,and the observation group was given enteral nutrition support treatment for 1 month.The levels of inflammatory factors,acute physiology and chronic health scoreⅡ(APACHEⅡ)and nutritional indicators of the two groups of patients were observed.Results Compared with before treatment,serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)levels were all decreased in the two groups after treatment,and the differences were statistically significant(P<0.05),and the serum CRP level of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in APACHEⅡbetween the control group and the observation group(P>0.05);after treatment,the APACHEⅡof the observation group was lower than the control group,and the difference was statistically significant(P<0.05).Compared with before treatment,the levels of ALB and Hb of the two groups of patients were significantly increased after treatment,and the blood amylase levels were significantly reduced,and the differences were statistically significant(P<0.05);after treatment,the ALB level of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in Hb and blood amylase levels between the observation group and the control group after treatment(P>0.05).Conclusion Enteral nutrition therapy can reduce the levels of inflammatory factors and APACHEⅡin SAP patients,improve the nutritional status of patients,and help patients recover.