摘要
目的:探讨合生元制剂联合谷氨酰胺对重症急性胰腺炎(SAP)病人行早期肠内营养(EEN)肠道耐受性及营养状况的影响。方法:前瞻性选取2020年1月至2021年6月,联勤保障部队第九〇〇医院普通外科收治的78例SAP病人为研究对象,随机分为对照组(n=39)与实验组(n=39)。入院24~48 h内置入鼻空肠管进行EEN治疗。对照组给予含谷氨酰胺的肠内营养混悬液,实验组在前者基础上给予合生元制剂(双歧杆菌三联活菌+蔗果低聚糖)。比较两组病人干预后的每日胃排空情况(胃残余量),干预7 d后肠内营养喂养不耐受症状、营养指标[血清运铁蛋白(TF)、白蛋白(ALB)、前白蛋白(PA)]。结果:干预后,实验组每日胃排空情况明显优于对照组,差异有统计学意义(P<0.05)。干预7 d后,实验组腹胀、腹痛、腹泻发生率显著低于对照组,差异有统计学意义(P<0.05),而恶心、呕吐发生率与对照组比较无统计学意义(P>0.05)。两组营养状况指标较干预前均有明显提升,且实验组干预后明显高于对照组,差异有统计学意义(P<0.05)。结论:给予合生元制剂联合谷氨酰胺的肠内营养混悬液能够有效提高SAP病人EEN耐受性,改善其营养状况。
Objective:To investigate the effect of synbionic combined with glutamine on the tolerance of early enteral nutrition(EN)and nutritional status in patients with severe acute pancreatitis(SAP).Methods:A total of 78SAP patients from January 2020 to June 2021 were included in the study and were randomized into control groups(n=39)and experimental groups(n=39).Feeding pathway with nasogastric tube was established and early EN treatment was initiated within 24~48 hours after admission.Patients in the control group was treated with glutamine-containing enteral nutrient suspension whereas those in the experimental group was treated with synbiotic preparation(triple viable bifidobacterium+sucrose oligosaccharides)and enteral nutrition.The gastric residual volumes in both groups were estimated every day.Symptoms of enteral feeding intolerance and nutritional status(serum ferritin,albumin,proalbumin)were observed 7 days after treatment.Results:The daily gastric residue volumes in the experimental group were significantly lower than that in the control group(P<0.05).After 7 days of treatment,the incidence of bloating,abdominal pain and diarrhea in the experimental group was significantly lower than those in the control group(P<0.05),while the incidence of nausea and vomiting was similar between the two groups(P>0.05).The nutritional status of both groups were improved after nutritional intervention(P<0.05).Nutritional outcome after nutrition support in the experimental group was better than that in the control group(P<0.05).Conclusion:Symbiotic combined with glutamine is associated with lower intolerance after early EN and improves the nutritional status in patients with SAP.
作者
洪伟煊
王梅平
肖春红
张再重
祁亚峰
王烈
HONG Wei-xuan;WANG Mei-ping;XIAO Chun-hong;ZHANG Zai-zhong;QI Ya-feng;WANG Lie(Department of General Surgery,Clinical Teaching Hospital of Fujian University of Traditional Chinese Medicine/the 900th Hospital of The Joint Logistics Support Force of Chinese PLA,Fuzhou 350025,Fujian,China)
出处
《肠外与肠内营养》
CAS
CSCD
北大核心
2022年第2期85-88,共4页
Parenteral & Enteral Nutrition
基金
福建省自然科学基金面上项目(2020J01113&2021J011262)
联勤保障部队第九〇〇医院院内课题(2020L01&2020L26&2021MS24)。
