本文選題：營養(yǎng)支持 + 重癥急性胰腺炎��； 參考：《中國老年學(xué)雜志》2017年15期

【摘要】：目的探討不同營養(yǎng)支持對老年重癥急性胰腺炎(SAP)患者的療效及對炎癥因子和腸道黏膜屏障功能的影響。方法選擇老年SAP患者97例,按照營養(yǎng)方法不同分為腸內(nèi)組50例與腸外組47例。腸內(nèi)組給予腸內(nèi)營養(yǎng)治療,腸外組給予腸外營養(yǎng)治療。比較兩組腹痛緩解時(shí)間、腸鳴音恢復(fù)時(shí)間、腹脹緩解時(shí)間、血淀粉酶和尿淀粉酶恢復(fù)時(shí)間,治療前和治療后血清炎癥因子、腎功能及腸道黏膜屏障功能水平變化。結(jié)果腸內(nèi)組腹痛緩解時(shí)間、腸鳴音恢復(fù)時(shí)間及腹脹緩解時(shí)間明顯快于腸外組(t=8.541、6.536、7.926,均P0.05);腸內(nèi)組血淀粉酶和尿淀粉酶恢復(fù)時(shí)間明顯快于腸外組(t=6.745、7.632,均P0.05);腸內(nèi)組治療后血清白細(xì)胞介素(IL)-6和腫瘤壞死因子(TNF)-α水平低于腸外組(t=20.708、10.839,均P0.05);腸內(nèi)組治療后尿素氮(BUN)和血肌酐(Scr)水平低于腸外組(t=10.765、7.331,均P0.05);腸內(nèi)組治療后D-乳酸、二胺氧化酶(DAO)和內(nèi)毒素水平低于腸外組(t=16.695、18.152、14.081,均P0.05)。結(jié)論腸內(nèi)營養(yǎng)支持治療對老年SAP患者效果明顯,且可改善患者炎癥反應(yīng)和腸道黏膜屏障功能。
[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- 偽 in TNF- 偽 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.
【作者單位】： 武漢市紅十字會(huì)醫(yī)院重癥醫(yī)學(xué)科;
【分類號】：R576

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