不同营养支持对老年重症急性胰腺炎患者的疗效及对炎症因子和肠道黏膜屏障功能的影响

发布时间：2018-05-23 21:31

本文选题：营养支持 + 重症急性胰腺炎　；参考：《中国老年学杂志》2017年15期

【摘要】：目的探讨不同营养支持对老年重症急性胰腺炎(SAP)患者的疗效及对炎症因子和肠道黏膜屏障功能的影响。方法选择老年SAP患者97例,按照营养方法不同分为肠内组50例与肠外组47例。肠内组给予肠内营养治疗,肠外组给予肠外营养治疗。比较两组腹痛缓解时间、肠鸣音恢复时间、腹胀缓解时间、血淀粉酶和尿淀粉酶恢复时间,治疗前和治疗后血清炎症因子、肾功能及肠道黏膜屏障功能水平变化。结果肠内组腹痛缓解时间、肠鸣音恢复时间及腹胀缓解时间明显快于肠外组(t=8.541、6.536、7.926,均P0.05);肠内组血淀粉酶和尿淀粉酶恢复时间明显快于肠外组(t=6.745、7.632,均P0.05);肠内组治疗后血清白细胞介素(IL)-6和肿瘤坏死因子(TNF)-α水平低于肠外组(t=20.708、10.839,均P0.05);肠内组治疗后尿素氮(BUN)和血肌酐(Scr)水平低于肠外组(t=10.765、7.331,均P0.05);肠内组治疗后D-乳酸、二胺氧化酶(DAO)和内毒素水平低于肠外组(t=16.695、18.152、14.081,均P0.05)。结论肠内营养支持治疗对老年SAP患者效果明显,且可改善患者炎症反应和肠道黏膜屏障功能。
[Abstract]:Objective to investigate the effects of different nutritional support on inflammatory factors and intestinal mucosal barrier function in elderly patients with severe acute pancreatitis (SAP). Methods 97 elderly patients with SAP were divided into enteral group (n = 50) and parenteral group (n = 47). Enteral group was treated with enteral nutrition and parenteral group was treated with parenteral nutrition. The remission time of abdominal pain, the recovery time of bowel sound, the time of abdominal distension relief, the recovery time of blood amylase and urine amylase, the changes of serum inflammatory factors, renal function and intestinal mucosal barrier function were compared between the two groups before and after treatment. Results the relief time of abdominal pain in enteral group, The recovery time of bowel sound and abdominal distention was significantly faster than that of extraintestinal group (P 0.05), the recovery time of serum amylase and urine amylase in intestinal group was significantly faster than that of parenteral group (P 0.05), and the recovery time of blood amylase and urine amylase in intestinal group was significantly faster than that in parenteral group (P < 0.05). The levels of TNF- 伪 in TNF- 伪 were lower than those in the parenteral group (P 0.05), but the levels of bun (bun) and creatinine in the intestinal group were lower than those in the parenteral group (P < 0.05), and the levels of bun and creatinine in the enteral group were lower than those in the parenteral group (P < 0.05), and the levels of serum creatinine in the enteral group were lower than those in the control group (P < 0.05). The levels of diamine oxidase (Dao) and endotoxin were lower than those in the parenteral group (P 0.05). Conclusion Enteral nutrition support therapy is effective in elderly patients with SAP and can improve inflammatory reaction and intestinal mucosal barrier function.
【作者单位】：武汉市红十字会医院重症医学科;
【分类号】：R576

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