摘要
目的探讨血糖管理联合肠内免疫营养支持对急性胰腺炎患者恢复的近远期影响。方法选择2019年12月至2020年12月在郑州市第七人民医院重症医学科救治的88例急性胰腺炎患者进行研究,用随机数字表法分为实验组与对照组,各44例。实验组接受血糖管理联合肠内免疫营养治疗,对照组仅接受肠内免疫营养支持,对比两组血糖变异性、炎性指标、免疫指标及预后差异。结果治疗后,实验组糖化血红蛋白(HbA1C)、血糖值标准差(GLuSD)、血糖不稳定指数(GLI)及平均血糖波动幅度(MAGE)明显低于对照组,差异有统计学意义(P<0.05);实验组治疗后第3天、第7天时C反应蛋白(CRP)及肿瘤坏死因子(TNF-α)水平显著低于对照组,差异有统计学意义(P<0.05);实验组住院期间并发症发生率、病死率显著低于对照组,差异有统计学意义(P<0.05);实验组患者血糖达标时间、平均监护时数、呼吸机使用时长、住院时间明显短于对照组,两组对比,差异有统计学意义(P<0.05);随访3个月,实验组血清白蛋白(ALB)、血红蛋白(Hb)及前白蛋白(PA)水平显著高于对照组,差异有统计学意义(P<0.05)。治疗14 d后,患者谷丙转氨酶(ALT)、谷草转氨酶(AST)及总胆红素(TBIL)水平明显降低,但组间对比,差异无统计学意义(P>0.05)。结论血糖管理联合肠内免疫营养支持有助于控制血糖变异,缓解炎症,降低患者并发症及病死风险,同时有助于远期患者营养指标的改善。
Objective To explore the near and long-term effect of blood glucose management and enteral immune nutrition support on recovery in patients with acute pancreatitis.Methods A total of 88 patients with acute pancreatitis treated in the Department of Critical Care Medicine of the Seventh People's Hospital of Zhengzhou from December 2019 to December 2020 were selected for the study.They were divided into experimental group and control group by random number table method,with 44 cases in each group.The experimental group accept blood glucose management combined with enteral immune nutrition therapy,control group only accept enteral immune nutrition support,compare the two groups of blood glucose variability,inflammatory index,immune index and prognosis difference.Results After treatment,glycated hemoglobin A1c(HbA1C),blood glucose value standard deviation(GLuSD),glycemic lability index(GLI)and mean amplitude of glycemic excursions(MAGE)in the experimental group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05);The levels of C-reactive protein(CRP)and tumor necrosis factor(TNF-α)on days 3 and 7 in the experimental group were significantly lower than those in the control group,and the differences were significant(P<0.05);The complication rate and mortality rate of the experimental group were significantly lower than those of the control group,and the differences were significant(P<0.05);In the experimental group,the blood glucose standard time,average monitoring time,ventilator use duration and hospital stay were significantly shorter than those of the control group,and the differences between the two groups were statistically significant(P<0.05);At 3 months of follow-up,serum albumin(ALB),hemoglobin(Hb)and prealbumin(PA)levels in the experimental group were significantly higher than the control group,with significant differences(P<0.05).After 14 days of treatment,the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total biliru
作者
赵玉玲
李倩
孙建丽
ZHAO Yuling;LI Qian;SUN Jianli(Fifth Department of Cardiac Surgery,Zhengzhou Seventh People's Hospital,Zhengzhou Henan 450000,China;Tenth Department of Cardiac Surgery,Zhengzhou Seventh People's Hospital,Zhengzhou Henan 450000,China;Second Department of General Surgery,Zhengzhou Seventh People's Hospital,Zhengzhou Henan 450000,China)
出处
《临床研究》
2023年第6期73-76,共4页
Clinical Research
关键词
血糖管理
肠内免疫营养支持
急性胰腺炎
营养指标
远期疗效
blood glucose management
enteral immune nutrition support
acute pancreatitis
nutritional indicators
longterm efficacy
