基于倾向性匹配法分析肠内营养支持在重症急性胰腺炎患者中的作用

Analysis of the effect of enteral nutritional support in patients with severe acute pancreatitis by propensity matching method

目的:探讨肠内营养支持在重症急性胰腺炎(SAP)患者中的作用。方法:选取2014年12月~2022年1月合肥市第一人民医院收治的198例SAP患者,根据有无肠内营养支持分为无肠内营养组(103例)和肠内营养组(95例)。利用倾向性匹配法设计,比较匹配后两组治疗前后的营养指标、免疫功能指标、住院时间、出院时体质量指数(BMI)及治疗期间并发症发生率。结果:经倾向性评分获得82对患者,在治疗过程中由于脱落等原因剔除10对,最终纳入72对患者为研究对象。治疗后肠内营养组ALB、PA、TRF、lgA、lgG水平,CD3^(+)、CD4^(+)占比及出院时BMI均高于无肠内营养组,治疗期间并发症总发生率(9.72%)低于无肠内营养组(23.61%)(P<0.05),两组患者住院时间[(28.89±5.76)d vs.(30.08±6.32)d]差异无统计学意义(P>0.05)。结论:在常规治疗的基础上给予肠内营养支持能够有效改善SAP患者的营养状态,提高免疫功能,且并发症少。

Objective:To investigate the effect of enteral nutrition support in patients with severe acute pancreatitis(SAP).Methods:198 SAP patients treated in our hospital were included from December 2014 to January 2022,and divided into non-enteral nutrition group(n=103)and enteral nutrition group(n=95)according to presence or absence of enteral nutrition support.The study was designed using propensity matching method(PSM),and the two groups were compared regarding the nutritional and immune function indexes before and after treatment,length of hospital stay,body mass index(BMI)at discharge and the incidence of complications during treatment.Results:Eighty-two pairs of patients were obtained through propensity score.However,10 pairs were excluded due to withdrawal during treatment,and 72 pairs of patients were finally included as the study subjects.After treatment,the levels of albumin(ALB),prealbumin(PA),transferrin(TRF),IgG,IgG,CD3^(+),CD4^(+)and BMI at discharge were higher in the enteral nutrition group than in the non-enteral nutrition group.Patients in the enteral nutrition group had lower incidence of complications during treatment than those in the non-enteral nutrition group(9.72%vs.23.61%,P<0.05),yet there was no significant difference in length of hospital stay between the two groups(P>0.05).Conclusion:Enteral nutrition support on the basis of conventional treatment can effectively improve the nutritional status of patients with SAP,improve immune function,and produce fewer complications.