酪酸梭菌活菌散联合肠内营养在重症急性胰腺炎治疗中的应用

发布时间：2018-05-22 21:05

本文选题：重症急性胰腺炎 + 酪酸梭菌活菌散　；参考：《广东医学》2015年03期

【摘要】：目的探讨酪酸梭菌活菌散联合肠内营养在重症急性胰腺炎(SAP)治疗中的应用价值。方法将54例SAP患者按营养支持不同分为观察组28例和对照组26例。两组均给予常规综合治疗,观察组待全身情况稳定后,开始实行早期肠内营养,并通过鼻空肠营养管注入酪酸梭菌活菌散,持续至经口进食;对照组全程治疗使用全胃肠外营养。监测两组患者血白细胞介素-8(IL-8)、C-反应蛋白(CRP)和淀粉酶水平,观察两组患者腹痛和腹胀持续时间、腹部压痛持续时间、血淀粉酶异常持续时间、发热持续时间,并比较两组患者并发症发生率、病死率、住院时间及住院费用。结果治疗后,两组血IL-8、CRP和淀粉酶水平均较治疗前下降(P0.05),而观察组较对照组下降更明显(P0.05)。观察组腹痛和腹胀持续时间、腹部压痛持续时间、血淀粉酶异常持续时间、发热持续时间均较对照组缩短(P0.05)。观察组并发症发生率低于对照组(P0.05),住院时间及住院费用少于对照组(P0.05),但两组病死率比较差异无统计学意义(P0.05)。结论酪酸梭菌活菌散联合肠内营养在SAP治疗中安全有效,在减少并发症及降低费用等方面都优于全胃肠外营养,值得临床推广应用。
[Abstract]:Objective to investigate the clinical value of Clostridium caseinate active powder combined with enteral nutrition in the treatment of severe acute pancreatitis (SAP). Methods 54 patients with SAP were divided into observation group (n = 28) and control group (n = 26) according to nutritional support. Both groups were given routine comprehensive treatment, the observation group after the stability of the whole body, began to implement early enteral nutrition, and through the naso-jejunal nutrition tube injection of Clostridium caseinate live bacteria powder, continue to eat through the mouth; The control group was treated with total parenteral nutrition. The serum levels of serum interleukin-8 (IL-8) and C-reactive protein (CRP) and amylase were measured. The duration of abdominal pain and distension, the duration of abdominal tenderness, the duration of abnormal blood amylase and the duration of fever were observed. The incidence of complications, mortality, length of stay and cost of hospitalization were compared between the two groups. Results after treatment, the levels of serum IL-8 CRP and amylase in both groups were lower than those before treatment, while the levels of serum IL-8 CRP and amylase in the observation group were significantly lower than those in the control group. The duration of abdominal pain, abdominal distention, abdominal tenderness, abnormal serum amylase and fever in the observation group were shorter than those in the control group (P 0.05). The incidence of complications in the observation group was lower than that in the control group (P 0.05), and the hospitalization time and expenses were less than that in the control group (P 0.05), but there was no significant difference in the mortality between the two groups (P 0.05). Conclusion Clostridium caseate active powder combined with enteral nutrition is safe and effective in the treatment of SAP. It is better than total parenteral nutrition in reducing complications and reducing cost. It is worth popularizing and applying in clinic.
【作者单位】：黄河中心医院消化内科;黄河中心医院药剂科;
【分类号】：R576

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