埃索美拉唑联合早期肠内生态免疫营养对重症急性胰腺炎患者肠黏膜屏障功能的影响

发布时间：2018-05-02 05:58

本文选题：胰腺炎 + 肠道营养　；参考：《中国全科医学》2015年20期

【摘要】：目的探讨埃索美拉唑联合早期肠内生态免疫营养(EIN)治疗对重症急性胰腺炎(SAP)患者肠黏膜屏障功能的影响。方法选择河南科技大学第一附属医院消化内科及ICU于2012年1月—2014年6月收治的68例SAP患者为研究对象,依据不同营养方法将患者分为全肠外营养组(TPN组,n=21)、EIN组(n=24)和埃索美拉唑联合EIN组(E+EIN组,n=23),检测并对比分析3组治疗前后肠黏膜屏障指标,包括血浆内毒素、D-乳酸、二胺氧化酶(DAO)水平及尿乳果糖与甘露醇比值(L/M)的差异。结果治疗后第7、14天,3组患者各黏膜屏障指标均低于治疗前,差异有统计学意义(P0.05),EIN组、E+EIN组患者治疗后血浆内毒素、D-乳酸、DAO水平及尿L/M低于TPN组,E+EIN组低于EIN组,差异有统计学意义(P0.05)。结论埃索美拉唑联合EIN可有效保护肠黏膜屏障,维护肠道黏膜屏障的完整性,疗效优于单纯EIN和TPN。
[Abstract]:Objective to investigate the effect of esomeprazole combined with early enteral ecologic immune nutrition (EIN) on intestinal mucosal barrier function in patients with severe acute pancreatitis (SAP). Methods Sixty-eight patients with SAP were selected from Department of Digestive Medicine, the first affiliated Hospital of Henan University of Science and Technology and ICU from January 2012 to June 2014. According to different nutrition methods, the patients were divided into total parenteral nutrition group (TPN group) and esomeprazole combined with EIN group (EIN group). The intestinal mucosal barrier indexes, including plasma endotoxin and D-lactic acid, were detected and compared before and after treatment. The difference of the level of diamine oxidase (Dao) and the ratio of lactulose to mannitol (L / M). Results the indexes of mucosal barrier in 3 groups were lower than those before treatment on the 7th and 14th day after treatment, and the difference was statistically significant (P 0.05). The levels of plasma endotoxin D- lactate dodo and urine L / M in E EIN group were lower than those in TPN E EIN group and EIN group. The difference was statistically significant (P 0.05). Conclusion esomeprazole combined with EIN can effectively protect intestinal mucosal barrier and maintain the integrity of intestinal mucosal barrier.
【作者单位】：河南科技大学第一附属医院消化内科;河南科技大学第一附属医院骨外科;南方医科大学南方医院消化内科;
【分类号】：R576

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