早期肠内营养干预对急性重症胰腺炎患者影响分析

Effect of Early Enteral Nutrition Intervention on Patients With Severe Acute Pancreatitis

目的探讨早期肠内营养干预对急性重症胰腺炎(severe acute pancreatitis,SAP)患者胃肠功能和肠道黏膜屏障功能的影响。方法选择我院于2017年12月—2019年12月收治的SAP患者122例,依据随机数字表法分为观察组和对照组,每组各61例。对照组患者给予埃索美拉唑治疗,观察组在对照组基础上结合早期肠内营养干预治疗,两组疗程均为14 d。分析两组患者血清中胰腺炎相关生化指标、临床症状改善、胃肠功能相关指标、肠道黏膜屏障功能相关指标变化情况。结果观察组血淀粉酶和尿淀粉酶恢复时间快于对照组(P<0.05)。观察组腹痛和腹胀缓解时间快于对照组(P<0.05)。两组治疗后胃动素水平较治疗前升高,而胃泌素和血管活性肠肽(vasoactineintrestinal peptide,VIP)水平较治疗前降低(P<0.05);观察组治疗后胃动素水平高于对照组,而胃泌素和VIP水平低于对照组(P<0.05)。两组治疗后D-乳酸、内毒素和血清二胺氧化酶(serum diamine oxidase,DAO)水平较治疗前降低(P<0.05);观察组治疗后后D-乳酸、内毒素和DAO水平低于对照组(P<0.05)。结论早期肠内营养干预对SAP患者效果良好,可改善患者胃肠功能和肠道黏膜屏障功能。

Objective To investigate the effect of early enteral nutrition intervention on gastrointestinal function and intestinal mucosal barrier function in patients with severe acute pancreatitis(SAP).Methods From December 2017 to December 2019,122 patients with SAP were divided into observation group and control group by random number table method,with 61 cases in each group.The control group was treated with esomeprazole,and the observation group was treated with early enteral nutrition intervention on the basis of the control group.The course of treatment in both groups was 14 days.The changes of serum pancreatitis related biochemical indexes,clinical symptom improvement,gastrointestinal function related indexes and intestinal mucosal barrier function related indexes in two groups were analyzed.Results The recovery time of serum amylase and urine amylase in the observation group were faster than those in the control group(P<0.05).The relieving time of abdominal pain and distention in the observation group were faster than those in the control group(P<0.05).After treatment,the level of motilin in the two groups were higher than those before treatment,while the level of gastrin and vasoactineintrestinal peptide(VIP)were lower than those before treatment(P<0.05);after treatment,the level of motilin in the observation group were higher than those in the control group,while the level of gastrin and VIP were lower than those in the control group(P<0.05).After treatment,the levels of D-lactic acid,endotoxin and serum diamine oxidase(DAO)in the two groups were lower than those before treatment(P<0.05);the levels of D-lactate,endotoxin and DAO in the observation group were lower than those in the control group(P<0.05).Conclusion Early enteral nutrition intervention can improve gastrointestinal function and intestinal mucosal barrier function in SAP patients.