早期肠内营养在重症急性胰腺炎治疗中的效果观察

Effect observation of early enteral nutrition in the treatment of severe acute pancreatitis

目的 分析早期肠内营养(EEN)在重症急性胰腺炎患者治疗中的效果。方法 62例重症急性胰腺炎患者,应用数字双盲法分为对照组和实验组,每组31例。实验组实施早期肠内营养治疗,对照组进行延迟肠内营养治疗。比较两组患者治疗效果以及治疗前后的营养状态指标[血清白蛋白(ALB)、总蛋白(TP)、血红蛋白(Hb)、前白蛋白(PA)]、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、炎性因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]水平。结果 实验组治疗总有效率96.77%高于对照组的80.65%,差异具有统计学意义(P<0.05)。治疗后,实验组患者ALB(29.78±3.28)g/L、TP(69.78±8.28)g/L、Hb(117.43±6.21)g/L、PA(100.87±20.16)mg/L均高于对照组的(27.86±3.09)g/L、(57.86±8.09)g/L、(113.63±6.03)g/L、(90.07±20.17)mg/L,差异具有统计学意义(P<0.05)。治疗后,实验组患者CD4^(+)(49.58±3.02)%、CD4^(+)/CD8^(+)(2.25±0.29)均高于对照组的(47.52±3.16)%、(1.97±0.28),CD8^(+)(22.05±2.98)%低于对照组的(24.12±2.86)%,差异具有统计学意义(P<0.05)。治疗后,实验组患者TNF-α(10.17±2.17)pg/ml、IL-6(5.47±1.85)pg/ml均低于对照组的(12.37±2.09)、(7.01±1.89)pg/ml,IL-10(15.48±3.48)pg/ml高于对照组的(13.78±3.16)pg/ml,差异具有统计学意义(P<0.05)。结论 给予重症急性胰腺炎患者早期肠内营养治疗具有理想效果,具有应用和推广的价值。

Objective To analyze the effect of early enteral nutrition(EEN)in the treatment of patients with severe acute pancreatitis.Methods A total of 62 patients with severe acute pancreatitis were divided into control group and experimental group by digital double-blind method,with 31 cases in each group.The experimental group received early enteral nutrition treatment,and the control group received delayed enteral nutrition treatment.Both groups were compared in terms of therapeutic effect,nutritional status indexes[serum albumin(ALB),total protein(TP),hemoglobin(Hb),prealbumin(PA)],immune function indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory factor indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-10(IL-10)]before and after treatment.Results The total effective rate of 96.77%in the experimental group was higher than that of 80.65%in the control group,and the difference was statistically significant(P<0.05).After treatment,the experimental group had ALB of(29.78±3.28)g/L,TP of(69.78±8.28)g/L,Hb of(117.43±6.21)g/L,and PA of(100.87±20.16)mg/L,which were higher than those of(27.86±3.09)g/L,(57.86±8.09)g/L,(113.63±6.03)g/L,and(90.07±20.17)mg/L in the control group,and the differences were statistically significant(P<0.05).After treatment,CD4^(+)and CD4^(+)/CD8^(+)in the experimental group were(49.58±3.02)%and(2.25±0.29),which were higher than those of(47.52±3.16)%and(1.97±0.28)in the control group;CD8^(+)of(22.05±2.98)%in the experimental group was lower than that of(24.12±2.86)%in the control group;all the differences were statistically significant(P<0.05).After treatment,TNF-αof(10.17±2.17)pg/ml and IL-6 of(5.47±1.85)pg/ml in the experimental group were lower than those of(12.37±2.09)and(7.01±1.89)pg/ml in the control group;IL-10 of(15.48±3.48)pg/ml in the experimental group was higher than that of(13.78±3.16)pg/ml in the control group;all the differences were statistically significant(P<0.05).Conclusion Early enteral nutrition has an ideal effect in patients with severe acute pancreatitis,and contains the value of application and popularization.