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肠内和肠外营养对重症急性胰腺炎的治疗作用 被引量:18

Clinical study on therapeutic effects of reasonable nourishment support on severe pancreatitis
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摘要 目的:探讨合理的营养方式对重症急性胰腺炎(SAP)患者治疗的作用。方法:将60例SAP患者随机分为全胃肠外营养支持(对照组)和肠内与肠外相结合营养支持(实验组)两组,分别检测血清前白蛋白、转铁蛋白、CD 4/CD 8比值和血清IgG水平、血清内毒素及尿乳果糖/甘露醇(L/M)比值,以监测两组患者营养状况、肠黏膜通透性和免疫状态的变化。结果:实验组治疗7 d后血清前白蛋白、转铁蛋白均较治疗前明显升高(P均<0.05),且实验组改善程度好于对照组。实验组治疗7 d和15 d血清内毒素及尿L/M值均低于对照组(P均<0.05)。治疗15 d后血清IgG和CD 4/CD 8比值均较7 d时明显升高(P均<0.05),且好于对照组(P均<0.05)。结论:肠内与肠外结合的营养支持方式可以改善SAP患者的营养状况,增强免疫力,维持肠黏膜屏障,对SAP患者治疗有积极的作用。 Objective: To investigate the therapeutic effects of the reasonable nourishment method on treatment of patients with severe pancreatitis. Methods: Sixty patients with severe pancreatitis were randomly divided into two groups: total parenteral nutrition (TPN) group and parenteral nutrition (PN) combined with enteral nutrition (EN) group. Changes of prealbumin (PAB), transferrin (TRF), ratio of CD4/CD8, IgG and endotoxin levels in serum as well as ratio of lactose and mannitol (L/M) in urine were observed to indicate the changes of nutrition, penetration of intestinal mucosa and immunity of the patients in both groups. Results: In PN combined with EN group, PAB and TRF in serum were higher at 7 days post-treatment compared to pre-treatment (all P〈0.05), and the changes were superior to those of the TPN group. Serum endotoxin level and L/M in urine in PN combined with EN group at 7 and 15 days post treatment were lower than those of the control group (allP〈0.05), and serum IgG and CD4/CD8 at 15 days post-treatment were obviously higher than those at 7 days post-treatment as well as those of the control group (both P〈0.05). Conclusion: PN combined with EN can improve the immunity and maintain the intestinal mucosa barrier of patients with severe pancreatitis, and play an important role in treatment of patients with severe pancreatitis.
出处 《中国中西医结合急救杂志》 CAS 2006年第4期244-246,共3页 Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词 胰腺炎 急性 重症 肠内营养 肠外营养 severe acute pancreatitis enteral nutrition parenteral nutrition
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