抑胰合剂联合肠内营养支持对重症急性胰腺炎患者的影响

Effect of Yiyi Mixture Combined with Enteral Nutrition Support on Patients with Severe Acute Pancreatitis

目的:探讨抑胰合剂联合肠内营养支持对重症急性胰腺炎(SAP)患者的影响。方法:选取2020年5月—2023年5月潜江市中心医院重症医学科收治的60例SAP患者。随机将其分为对照组和观察组,各30例。两组均给予常规治疗,对照组给予肠内营养支持,观察组在对照组的基础上给予抑胰合剂。比较两组围手术期指标,治疗前后肠胃激素、肠黏膜屏障指标、炎症因子及不良反应。结果:观察组恢复肛门排气时间、肠鸣音恢复时间、腹胀缓解时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,两组血管活性肠肽(VIP)水平均低于治疗前,胃动素(MTL)、生长抑素(SS)水平均高于治疗前,观察组VIP水平低于对照组,MTL、SS水平均高于对照组,差异有统计学意义(P<0.05)。治疗后,两组内毒素、二胺氧化酶、D-乳酸水平均低于治疗前,观察组内毒素、二胺氧化酶、D-乳酸水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平均低于治疗前,观察组TNF-α、IL-6、IL-8水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:抑胰合剂联合肠内营养支持治疗SAP患者能有效恢复胃肠动力,改善肠胃激素水平,缩短住院时间,增强肠黏膜屏障功能,减轻炎症反应,且具有一定安全性。

Objective:To explore the effect of Yiyi Mixture combined with enteral nutrition support on patients with severe acute pancreatitis(SAP).Method:A total of 60 SAP patients admitted to the Intensive Care Department of Qianjiang Central Hospital from May 2020 to May 2023 were selected.They were randomly divided into control group and observation group,30 cases in each group.Both groups were given routine treatment,control group was given enteral nutrition support,observation group was given Yiyi Mixture on the basis of control group.Perioperative indexes,gastrointestinal hormones,intestinal mucosal barrier indexes,inflammatory factors before and after treatment and adverse reactions were compared between the two groups.Result:The recovery time of anal exhaust,intestinal sound recovery time,abdominal distension relief time and hospital stay in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of vasoactive intestinal peptide(VIP)in both groups were lower than those before treatment,the levels of motilin(MTL)and somatostatin(SS)were higher than those before treatment,the VIP level in observation group was lower than that in control group,and the levels of MTL and SS were higher than those in control group,and the differences were statistically significant(P<0.05).After treatment,the levels of endotoxin,diamine oxidase and D-lactic acid in the two groups were lower than those before treatment,and the levels of endotoxin,diamine oxidase and D-lactic acid in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in both groups were lower than those before treatment,and the levels of TNF-α,IL-6,IL-8 in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Yiyi Mixture combined with enteral nutrition support in the treatment of SAP patients can effectively restore gastrointestinal motivity,improve gastrointestinal hormone levels,shorten hospital stay,enhance intestinal mucosal barrier function,reduce inflammation,and have certain safety.