超早期肠内营养在重症急性胰腺炎患者中的应用效果

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摘要目的研究超早期肠内营养在重症急性胰腺炎中的应用效果。方法回顾性选取2017年1月至2021年12月佛山市第二人民医院收治的100 例重症急性胰腺炎患者作为研究对象，根据肠内营养治疗开始的时间将其分为试验组与对照组，每组50 例。试验组患者采用超早期干预，具体为发病后24～48 h 进行肠内营养；对照组采用延迟干预，具体为发病后＞48～72 h 进行肠内营养。比较两组患者的治疗总有效率、C-反应蛋白（CRP）、白蛋白、血淀粉酶恢复时间、血脂肪酶恢复时间、住院时间、急性生理及慢性健康状况评估Ⅱ（APACHEⅡ）评分及并发症情况。结果试验组患者的治疗总有效率高于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的CRP、白蛋白水平比较，差异无统计学意义（P＞0.05）；治疗后，两组患者的CRP 水平低于治疗前，白蛋白水平高于治疗前，且试验组患者的CRP 水平低于对照组，白蛋白水平高于对照组，差异有统计学意义（P＜0.05）。试验组患者的血淀粉酶恢复时间、血脂肪酶恢复时间、住院时间均短于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的APACHEⅡ评分比较，差异无统计学意义（P＞0.05）；治疗后，两组患者的APACHEⅡ评分均低于治疗前，且试验组患者的APACHEⅡ评分低于对照组，差异有统计学意义（P＜0.05）。两组患者的并发症总发生率比较，差异无统计学意义（P＞0.05）。结论与延迟干预比较，超早期肠内营养可更有效地改善重症急性胰腺炎患者的营养水平和抑制其炎症反应，利于患者的恢复，值得临床推广应用。

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关键词 ：超早期, 肠内营养, 急性胰腺炎, 效果

Abstract：Objective To investigate the application effect of ultra-early enteral nutrition in the treatment of severe acute pancreatitis.Methods A total of 100 patients with severe acute pancreatitis admitted to the Second People′s Hospital of Foshan City from January 2017 to December 2021 were retrospectively selected as the research objects.They were divided into the experimental group and the control group according to the start time of enteral nutrition therapy,50 cases in each group.The experimental group was given ultra-early intervention,the patients were given enteral nutrition at 24-48 hours after the onset,the control group was given delayed intervention,and the patients were given enteral nutrition at ＞48-72 hours after the onset.The total effective rate,C-reactive protein (CRP),albumin,serum amylase recovery time,serum lipase recovery time,hospitalization time,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) scores and complications were compared between the two groups.Results The total effective rate of the experimental group was higher than that of the control group,the difference was statistically significant (P＜0.05).Before treatment,there were no significant differences in CRP and albumin levels between the two groups (P＞0.05).After treatment,the CRP levels of the two groups were lower than those before treatment,the albumin levels of the two groups were higher than those before treatment,and the CRP level of the experimental group was lower than that of the control group,and the albumin level of the experimental group was higher than that of the control group,the differences were statistically significant (P＜0.05).The serum amylase recovery time,serum lipase recovery time,hospitalization time in the experimental group were shorter than those in the control group,the differences were statistically significant (P＜0.05).Before treatment,there was no significant difference in APACHEⅡscore between the two groups (P＞0.05).After treatment,the APACHEⅡscores of the two groups were lower than those before treatment,and the APACHEⅡscore of the experimental group was lower than that of the control group,the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of complications between the two groups (P＞0.05).Conclusion Compared with delayed intervention,ultra-early enteral nutrition can more effectively improve the nutritional level and inhibit the inflammatory reaction of severe acute pancreatitis patients,and is conducive to the recovery of patients.It is worthy of clinical application.

Key words： Ultra-early Enteral nutrition Acute pancreatitis Effect

引用本文:

曲黔；陆曼；黎兰青. 超早期肠内营养在重症急性胰腺炎患者中的应用效果[J]. 中国当代医药, 2022, 29(22): 38-41.
QU Qian LU Man LI Lanqing. Application effect of ultra-early enteral nutrition in patients with severe acute pancreatitis. 中国当代医药, 2022, 29(22): 38-41.

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[1]	Mounzer R，Langmead CJ，Wu BU，et al.Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis[J].Gastroenterology，2012，142（7）：1476-1482.
[2]	Greenberg JA，Hsu J，Bawazeer M，et al.Clinical practice guideline：management of acute Pancreatitis[J].Can J Surg，2016，59（2）：128-140.
[3]	Mirtallo JM，Forbes A，Mcclave SA，et al.International consensus guidelines for nutrition therapy in pancreatitis[J].PEN J Parenter Enteral Nutr，2012，36（3）：284-291.
[4]	Sun J，Li W，Ke L，et al.Early enteral nutrition prevents intraabdominal hypertension and reduces the severity of severe acute pancreatitis compared with delayed enteral nutrition：a prospective pilot study[J].World J surg，2013，37（9）：1-8.
[5]	苗祥，昝建宝，宋康颉，等.早期肠内营养对重症急性胰腺炎患者血清CRP 及T 淋巴细胞亚群的影响[J].肝胆胰外科杂志，2013，25（2）：116-118.
[6]	刘杰锋，何志国，陈澍，等.早期肠内营养辅助治疗重症胰腺炎的临床疗效分析[J].现代生物医学进展，2013，13（27）：5279-5281.
[7]	中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南（2021）[J].中华普通外科杂志，2021，59（7）：578-587.
[8]	中国医师协会胰腺病学专业委员会.中国急性胰腺炎多学科诊治（MDT）共识意见（草案）[J].中国实用内科杂志，2015，35（12）：1004-1009.
[9]	王静，金霞霞，卢国光，等.有核红细胞联合Ranson 评分及APACHEⅡ评分构建重症急性胰腺炎患者的结局预测模型[J].中华检验医学杂志，2020，43（1）：63-70.
[10]	徐铂然，侯国方，吴川林，等.急性胰腺炎营养支持治疗的最新进展[J].国际外科学杂志，2019，46（5）：339-344.
[11]	朱锋，殷稳柱，方向明.《2018年美国胃肠病协会急性胰腺炎初始处理指南》更新解读[J].医学新知杂志，2019，29（2）：134-137.
[12]	冯磊，张轶，徐德全，等.急性胆源性胰腺炎诊治进展[J].中国普外基础与临床杂志，2019，26（4）：508-512.
[13]	许春芳，黄晓曦，沈云志，等.肠内营养与肠外营养对重症急性胰腺炎患者肠屏障功能影响的比较[J].中华内科杂志，2011，50（5）：370-373.
[14]	Lugli AK，Carli F，Wykes L.The importance of nutrition status assessment：the case of severe acute pancreatitis[J].Nutr Rev，2007，65（7）：329-334.
[15]	赵刚，吴泽宇，万进.早期肠内营养对重症急性胰腺炎治疗的影响[J].实用医学杂志，2008，24（7）：1130-1132.
[16]	季占峰，李月华，张红霞，等.早期要素肠内营养与肠外、肠内阶段性营养治疗急性重症胰腺炎的对比研究[J].实用医学杂志，2010，26（4）：581-583.
[17]	徐昉，汪飞，周发春.早期肠内营养对重症急性胰腺炎患者临床预后的随机对照研究[J].现代预防医学，2012，39（4）：801-803.
[18]	朱帅，黄耿文.WSES 重症急性胰腺炎管理指南（2019）解读[J].中国普通外科杂志，2019，28（9）：1048-1053.
[19]	李姝艺，李双庆.重症急性胰腺炎治疗中肠内营养的研究进展[J].中国全科医学，2019，22（3）：324-328.
[20]	吴玉洪.前列地尔联合生长抑素治疗重症急性胰腺炎患者的效果[J].医疗装备，2018，31（18）：152-153.