肠内营养支持联合益生菌对重症急性胰腺炎合并慢重症患者肠道功能和预后的影响Effect of enteral nutrition support combined with probiotics on intestinal function and prognosis in patients with severe acute pancreatitis complicated with chronically critical ill
徐亚楠;曹云霞;丁宁;
摘要(Abstract):
目的分析肠内营养支持联合益生菌对重症急性胰腺炎(severe acute pancreatitis,SAP)合并慢重症(chronically critical ill,CCI)患者肠道功能和预后的影响。方法选取2018年4月至2021年4月首都医科大学附属北京友谊医院收治的64例SAP合并CCI患者为研究对象,使用随机数字表法将入选患者分别纳入联合组和对照组,每组各32例。两组患者均予常规综合治疗,并给予早期肠内营养支持,联合组患者加用益生菌治疗,持续14 d。对比两组患者治疗前后血清炎性因子、白蛋白、淀粉酶、肠黏膜屏障指标及胃肠功能评分、脱机率、并发症发生率、感染率、病死率、住院天数。结果两组患者治疗后血清C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)、内毒素、二胺氧化酶(diamine oxidase,DAO)、淀粉酶水平和胃肠功能评分均显著低于本组治疗前(均P<0.05),血清白蛋白水平均显著高于本组治疗前(均P<0.05)。联合组患者治疗后血清CRP、TNF-α、IL-6、内毒素、DAO、淀粉酶水平和胃肠功能评分均显著低于对照组(均P<0.05),血清白蛋白水平显著高于对照组(P<0.05)。联合组患者脱机率显著高于对照组(P<0.05),并发症发生率、感染率、病死率均显著低于对照组(均P<0.05),住院天数显著短于对照组(P<0.05)。结论在综合治疗和肠内营养支持的基础上,联合益生菌有助于减轻SAP合并CCI患者机体炎症反应,改善营养状况,提高肠黏膜屏障功能,促进胃肠功能恢复,从而提高脱机率、降低病死率,达到改善患者预后的目的。
关键词(KeyWords): 肠内营养;益生菌;重症急性胰腺炎;慢重症;肠道功能
基金项目(Foundation):
作者(Authors): 徐亚楠;曹云霞;丁宁;
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