重症急性胰腺炎患者出现肠源性感染的炎症指标与肠内营养支持治疗分析

发布时间：2018-04-15 14:44

本文选题：重症急性胰腺炎 + 白细胞计数　；参考：《中华医院感染学杂志》2017年02期

【摘要】：目的探究重症急性胰腺炎患者出现肠源性感染时的WBC、CRP及内毒素水平变化及肠内营养支持治疗的临床效果,为及早控制肠源性感染提供参考。方法选择2011年4月-2016年5月在医院进行治疗的64例重症急性胰腺炎并发肠源性感染患者为研究对象,入院后给予其肠内营养支持治疗,对比治疗前后患者的WBC、CRP及内毒素水平,并就治疗前后患者的各细胞免疫功能指标及营养相关性指标进行比较。结果给予肠内营养支持治疗后,并发肠源性感染患者的WBC、CRP及内毒素水平分别为(15.05±1.58)×109/L、(101.27±18.29)mg/L、(0.45±0.14)EU/ml,上述指标均有所好转,与治疗前的(18.22±2.36)×109/L、(165.24±31.52)mg/L、(0.97±0.23)EU/ml比较差异有统计学意义(P0.05);治疗后,肠源性感染患者的CD3、CD4及CD4/CD8分别为(71.03±4.24)%、(41.57±4.46)%、1.68±0.33,明显高于治疗前的(61.25±5.48)%、(30.14±3.18)%、1.12±0.24,治疗后的CD8为(25.73±2.58)%,明显低于治疗前的(28.16±3.25)%,差异有统计学意义(P0.05);治疗后,肠源性感染患者的ALB、PA以及TF水平分别为(36.28±5.49)g/L、(331.58±41.28)mg/L、(3.24±0.76)g/L,高于治疗前的(31.47±4.21)g/L、(221.45±28.16)mg/L、(2.13±0.51)g/L,各项营养指标提升幅度明显(P0.05)。结论重症急性胰腺炎患者在出现肠源性感染时,其WBC、CRP及内毒素明显偏高,通过给予其肠内营养支持治疗,可以降低其WBC、CRP及内毒素水平,其细胞免疫功能和营养状况得到显著改善,对于缓解其肠源性感染症状,减轻患者痛苦能够发挥积极作用。
[Abstract]:Objective to investigate the changes of WBCn CRP and endotoxin levels in patients with severe acute pancreatitis and the clinical effect of enteral nutrition support therapy in order to provide reference for early control of enterogenous infection.Methods Sixty-four patients with severe acute pancreatitis complicated with enterogenous infection who were treated in hospital from April 2011 to May 2016 were treated with enteral nutrition support therapy after admission. The levels of WBC CRP and endotoxin were compared before and after treatment.The indexes of cellular immune function and nutritional correlation were compared before and after treatment.Results after enteral nutrition support therapy, the levels of WBC CRP and endotoxin in patients with enterogenic infection were 15.05 卤1.58) 脳 109 / L, 101.27 卤18.29 mg / L, 0.45 卤0.14 EUP / ml, respectively. The above indexes were better than those before treatment (18.22 卤2.36) 脳 109 / L = 165.24 卤31.52mgL / L (0.97 卤0.23)EU/ml).The CD _ 3 CD _ 4 and CD4/CD8 of patients with enterogenic infection were 71.03 卤4.24 and 41.57 卤4.46, respectively, which were significantly higher than those before treatment (61.25 卤5.48) and before treatment (30.14 卤3.18 卤1.12 卤0.24, respectively). The CD8 after treatment was 25.73 卤2.58, which was significantly lower than that before treatment (28.16 卤3.25), the difference was significant (P 0.05).The levels of ALBPA and TF in patients with enterogenic infection were 36.28 卤5.49g / L, 331.58 卤41.28mg / L, 3.24 卤0.76g / L, respectively, which were higher than those before treatment (31.47 卤4.21g / L, 221.45 卤28.16mg / L, 2.13 卤0.51g / L, respectively).Conclusion the levels of WBCn CRP and endotoxin in patients with severe acute pancreatitis are significantly higher than those in patients with enterogenous infection. The levels of WBCfU CRP and endotoxin can be reduced by enteral nutrition support therapy in patients with severe acute pancreatitis.The cellular immune function and nutritional status were significantly improved, which could play a positive role in relieving the symptoms of enterogenic infection and alleviating the pain of patients.
【作者单位】：嵊州市中医院外科;浙江大学医学院附属邵逸夫医院肝胆胰外科;浙江大学医学院附属第二医院普通外科;
【基金】：浙江省中医药科技计划项目(2009B620014)
【分类号】：R576

【相似文献】