渐进式早期康复训练联合早期肠内营养支持对重症急性胰腺炎患者的干预效果观察

Observation on the intervention effect of progressive early rehabilitation training combined with early enteral nutrition support on patients with severe acute pancreatitis

目的探讨渐进式早期康复训练联合早期肠内营养支持对重症急性胰腺炎(SAP)患者的干预效果。方法120例SAP患者,按照随机数字表法分为对照组和观察组,每组60例。对照组予以常规护理,观察组实施渐进式早期康复训练联合早期肠内营养支持干预。比较两组患者症状改善情况以及干预前后营养状况、炎性因子、生活质量。结果观察组排便恢复时间(3.71±0.68)d、排气恢复时间(3.62±0.77)d、腹痛和腹胀改善时间(3.31±0.48)d、肠鸣音恢复时间(4.11±0.63)d均短于对照组的(4.33±1.16)、(4.35±1.03)、(3.97±0.92)、(4.82±0.92)d(P<0.05)。干预后,两组转铁蛋白、前白蛋白、白蛋白、血红蛋白均高于干预前,且观察组转铁蛋白(2.61±0.54)g/L、前白蛋白(0.30±0.09)g/L、白蛋白(48.77±4.03)g/L、血红蛋白(119.26±4.05)g/L均高于对照组的(2.03±0.45)、(0.25±0.06)、(39.22±3.76)、(112.02±3.72)g/L(P<0.05)。干预后,两组白细胞介素10(IL-10)高于干预前,C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)均低于干预前,且观察组IL-10(15.61±3.72)pg/ml高于对照组的(10.26±3.29)pg/ml,CRP(19.87±1.07)mg/L、TNF-α(12.77±2.15)pg/ml、IL-6(11.51±2.01)pg/ml均低于对照组的(62.77±1.52)mg/L、(59.77±4.13)pg/ml、(21.33±2.74)pg/ml(P<0.05)。干预后,两组社会功能、生理功能、心理功能、物质生活评分均高于对照组,且观察组社会功能评分(69.77±4.51)分、生理功能评分(62.79±5.61)分、心理功能评分(70.28±4.76)分、物质生活评分(60.55±5.72)分均高于对照组的(56.83±3.05)、(50.24±4.13)、(56.55±3.84)、(49.32±2.63)分(P<0.05)。结论将渐进式早期康复训练联合早期肠内营养支持应用于SAP患者的治疗中效果较好,能够调节机体炎性水平,加快症状改善,提升机体营养水平,提高生活质量。

Objective To explore the intervention effect of progressive early rehabilitation training combined with early enteral nutrition support on patients with severe acute pancreatitis(SAP).Methods According to the random number table method,120 SAP patients were divided into a control group and an observation group,with 60 patients in each group.The control group received routine care,while the observation group received progressive early rehabilitation training combined with early enteral nutrition support intervention.Comparison was made on the improvement of symptoms,nutritional status,inflammatory factors,and quality of life before and after intervention between two groups.Results In the observation group,the recovery time of defecation was(3.71±0.68)d,the exhaust recovery time was(3.62±0.77)d,the improvement time of abdominal pain and bloating was(3.31±0.48)d,and the recovery time of bowel sounds was(4.11±0.63)d,which were shorter than(4.33±1.16),(4.35±1.03),(3.97±0.92),and(4.82±0.92)d in the control group(P<0.05).After intervention,the transferrin,prealbumin,albumin and hemoglobin in both groups were higher than those before intervention;the observation group had transferrin of(2.61±0.54)g/L,prealbumin of(0.30±0.09)g/L,albumin of(48.77±4.03)g/L and hemoglobin of(119.26±4.05)g/L,which were higher than(2.03±0.45),(0.25±0.06),(39.22±3.76)and(112.02±3.72)g/L in the control group(P<0.05).After intervention,the interleukin-10(IL-10)in both groups was higher than that before intervention,and C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were lower than those before intervention;the interleukin-10(IL-10)of(15.61±3.72)pg/ml in the observation group was higher than(10.26±3.29)pg/ml in the control group;in the observation group,CRP was(19.87±1.07)mg/L,TNF-αwas(12.77±2.15)pg/ml,and IL-6 was(11.51±2.01)pg/ml,which were lower than(62.77±1.52)mg/L,(59.77±4.13)pg/ml,and(21.33±2.74)pg/ml in the control group(P<0.05).After intervention,the score of social function,physiological function,psychological function and material life in both groups were higher than those before intervention;in the observation group,the social function score was(69.77±4.51)points,the physiological function score was(62.79±5.61)points,the psychological function score was(70.28±4.76)points,and the material life score was(60.55±5.72)points,which were higher than(56.83±3.05),(50.24±4.13),(56.55±3.84),and(49.32±2.63)points in the control group(P<0.05).Conclusion The implementation of progressive early rehabilitation training combined with early enteral nutrition support in SAP patients has a significant effect,which can regulate the inflammatory level,accelerate the improvement of symptoms,improve the nutritional status of patients,and help improve the quality of life of patients.