免疫增强型肠内营养方案联合微创腹腔引流在重症急性胰腺炎中的临床应用

doi:10.3969/j.issn.1007-3205.2020.10.005

河北医科大学学报 ›› 2020, Vol. 41 ›› Issue (10): 1136-1139,1144.doi: 10.3969/j.issn.1007-3205.2020.10.005

免疫增强型肠内营养方案联合微创腹腔引流在重症急性胰腺炎中的临床应用

1.陕西省安康市中医医院急诊科,陕西安康 725000;2.陕西省安康市中医医院消化内科,陕西安康 725000

出版日期:2020-10-25 发布日期:2020-10-27
作者简介:米俊（1981-），男，陕西安康人，陕西省安康市中医医院主治医师，医学学士，从事急诊科疾病诊治研究。
基金资助:
陕西省创新能力支撑计划项目(2018KJXX-072)

Clinical application of immune-enhancing enteral nutrition combined with minimally invasive abdominal drainage in severe acute pancreatitis

1.Department of Emergency, Ankang Hospital of Traditional Chinese Medicine, Shaanxi Province,
Ankang 725000, China; 2.Department of Gastroenterology, Ankang Hospital of Traditional
Chinese Medicine, Shaanxi Province, Ankang 725000, China

Online:2020-10-25 Published:2020-10-27

摘要/Abstract

摘要： 目的探讨免疫增强型肠内营养方案联合微创腹腔引流应用于重症急性胰腺炎（severe acute pancreatitis，SAP）的临床效果。
方法回顾性分析SAP患者136例的临床资料，均常规采取微创腹腔引流等综合性治疗措施。根据肠内营养方式不同分为对照组62例（给予普通肠内营养治疗）和联合组74例（给予免疫增强型肠内营养方案）。于治疗前和治疗7 d后比较2组血清营养指标［白蛋白（albumin，Alb）、前白蛋白（prealbumin，PA）、转铁蛋白（transferrin，Tf）］、血清体液免疫指标［免疫球蛋白（immunoglobulin，Ig）A、IgG、IgM］变化，比较2组7 d、30 d病死率及基本康复指标差异。
结果 2组7 d病死率差异无统计学意义（P＞0.05）。联合组30 d病死率明显低于对照组（P＜0.05）。治疗7 d后，2组血清Alb、PA、Tf、IgA、IgG、IgM水平均明显高于治疗前，联合组血清Alb、PA、Tf、IgA、IgG、IgM水平明显高于对照组（P＜0.05）。联合组恢复进食时间、引流时间、住重症监护病房时间及住院时间均明显短于对照组（P＜0.05）。
结论免疫增强型肠内营养方案联合微创腹腔引流治疗SAP效果显著，有利于提高存活率，加快身体恢复。

关键词: 胰腺炎, 肠道营养, 引流术

Abstract: Objective To explore the clinical effects of immune-enhancing enteral nutrition combined with minimally invasive abdominal drainage on patients with severe acute pancreatitis(SAP).
Methods The clinical data of 136 patients with SAP were retrospectively analyzed. The patients were given routine comprehensive treatment measures including minimally invasive abdominal drainage. The patients were divided into control group(n=62, given ordinary enteral nutrition therapy) and combined group(n=74, given immune-enhancing enteral nutrition regimen) according to different enteral nutrition methods. The serum nutritional indicators［albumin(Alb), prealbumin(PA), transferrin(Tf)］ and serum humoral immune indexes［immunoglobulin(Ig) A, IgG, IgM］ were compared between two groups before treatment and after 7 d of treatment. The 7 d and 30 d mortality rates and basic rehabilitation indicators were compared between two groups.
Results There was no significant differences in the 7 d mortality rate between two groups(P＞0.05). The 30 d mortality rate in combined group was significantly lower than those in control group(P＜0.05). After 7 d of treatment, the levels of serum Alb, PA, Tf, IgA, IgG and IgM in two groups were significantly higher than those before treatment, and the levels of serum Alb, PA, Tf, IgA, IgG and IgM in combined group were significantly higher than those in control group(P＜0.05). The feeding recovery time, drainage time, intensive care unit(ICU) stay and hospital stay in combined group were significantly shorter than those in control group(P＜0.05).
Conclusion Immune-enhancing enteral nutrition combined with minimally invasive abdominal drainage has prominent effects in the treatment of SAP, and it is beneficial to improve the survival rate and accelerate the recovery of body.

Key words: pancreatitis, enteral nutrition, drainage

米俊, 华鹏, 崔翔, 周荣赛. 免疫增强型肠内营养方案联合微创腹腔引流在重症急性胰腺炎中的临床应用[J]. 河北医科大学学报, 2020, 41(10): 1136-1139,1144.

MI Jun, HUA Peng, CUI Xiang, ZHOU Rong-sai. Clinical application of immune-enhancing enteral nutrition combined with minimally invasive abdominal drainage in severe acute pancreatitis[J]. Journal of Hebei Medical University, 2020, 41(10): 1136-1139,1144.

[1]	张涛, 邹萍, 赵琦. 高脂血症胰腺炎患者血清血管紧张素转化酶2与巨噬细胞移动抑制因子水平检测及临床意义 [J]. 河北医科大学学报, 2023, 44(6): 724-728.
[2]	杜军卫, 靳君华. 急性胆源性胰腺炎发病危险因素分析 [J]. 河北医科大学学报, 2023, 44(12): 1448-1452.
[3]	吴宙光, 王斌, 左桃燕, 陈思琦, 付静茹, 张文杰. 早期肠内营养对胆道闭锁幼鼠的肠道黏膜结构及微生态保护作用的研究 [J]. 河北医科大学学报, 2022, 43(8): 872-876.
[4]	吴磊, 陈海山, 郑清华. 不同管饲法对脑卒中患者营养状况、吞咽功能及并发症的影响[J]. 河北医科大学学报, 2021, 42(6): 695-697,703.
[5]	张冰1，朱国玲2*，孙秋1，吉瑞更1. 开滦集团400例急性胰腺炎流行病学及危险因素分析[J]. 河北医科大学学报, 2020, 41(6): 723-727.
[6]	张健，刘贤，郭雅丽，李亚强，徐宝宏*. 甲磺酸加贝酯联合CBP治疗SAP的效果及对炎症“瀑布效应”相关因子的影响[J]. 河北医科大学学报, 2020, 41(3): 272-275,281.
[7]	吴丹1（综述），刘风侠2*（审校）. 重症脑出血术后患者肠内营养喂养不足研究进展#br#[J]. 河北医科大学学报, 2020, 41(2): 245-248.
[8]	何晨熙, 朱新影, 赵东强. 《2020国际共识：诊断性超声内镜在慢性胰腺炎管理中的作用》解读[J]. 河北医科大学学报, 2020, 41(12): 1365-1368.
[9]	张培建, 刘孟东, 刘科霞, 王雅琪, 刘旭光. 生长抑素预防ERCP术后高淀粉酶血症及胰腺炎疗效的研究[J]. 河北医科大学学报, 2020, 41(11): 1276-1280.
[10]	纪晨光，赵东强. 《2018国际指南：慢性胰腺炎截面影像学诊断和严重程度评分》解读[J]. 河北医科大学学报, 2019, 40(5): 501-503.
[11]	聂立敏，段〓洁，赵〓瑞，刘艳霞，方艳伟*. 不同冲封管方式对胰腺炎患者留置鼻肠管通畅性的比较研究[J]. 河北医科大学学报, 2019, 40(5): 603-606.
[12]	李赛莲，许保，陈正义，黄晓曦，王齐全. 艾普拉唑联合生长抑素治疗重症急性胰腺炎的效果及安全性分析[J]. 河北医科大学学报, 2019, 40(11): 1261-1264.
[13]	刘〓明，步建立. 负压封闭引流技术治疗复杂感染创面的效果观察#br#[J]. 河北医科大学学报, 2018, 39(2): 167-170.
[14]	王〓鹏1，刁文博2*，贾露露3，程〓杰4，赵〓建1，李〓京1. 基于骨钻的后外侧入路脊柱内镜术后渗出与术后反应的相关性分析[J]. 河北医科大学学报, 2018, 38(11): 1291-1295.
[15]	刘宏志. 穿刺引流微创术联合术后尿激酶溶解治疗高血压性脑出血患者的效果分析[J]. 河北医科大学学报, 2018, 38(10): 1158-1160,1165.

免疫增强型肠内营养方案联合微创腹腔引流在重症急性胰腺炎中的临床应用

Clinical application of immune-enhancing enteral nutrition combined with minimally invasive abdominal drainage in severe acute pancreatitis

HTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价