摘要
目的观察含强化精氨酸的肠内营养支持辅助治疗高脂血症性急性胰腺炎(HAP)的临床疗效。方法将70例HAP患者随机分为观察组和对照组各35例,两组均给予急性胰腺炎规范化治疗,同时对照组给予肠外营养支持,观察组先给予肠外营养支持,后经空肠营养管给予含强化精氨酸的肠内营养支持。观察两组患者腹部体征缓解所需时间和血、尿淀粉酶恢复正常所需时间;比较两组患者治疗前及治疗14 d后营养指标、体液免疫指标、细胞免疫指标和炎症反应指标水平。结果观察组腹痛、腹胀缓解所需时间及血、尿淀粉酶恢复正常所需时间均短于对照组(P<0.05)。治疗14 d后,两组血清白蛋白、前白蛋白、Ig A、Ig G、Ig M、淋巴细胞总数、CD3、CD4水平均较前升高(P<0.05),且观察组以上指标均高于对照组(P<0.05);两组C反应蛋白、肿瘤坏死因子-α、白细胞介素-6水平均较前下降(P<0.05),且观察组以上指标均低于对照组(P<0.05)。结论含强化精氨酸的肠内营养支持辅助治疗HAP能更加有效地缓解患者临床症状、改善营养状况及免疫功能、降低患者急性反应期炎症反应,预后和提高临床疗效更佳。
Objective To observe the clinical efficacy of enteral nutrition containing fortifier arginine on the treatment of hypedipidemic acute pancreatitis （HAP）. Methods Seventy patients with HAP were randomly divided into observation group and control group,with 35 cases in each group. All patients were treated with conventional treatment for acute pancreatitis. Meanwhile,the control group received parenteral nutrition support, and the observation group received parenteral nutrition support at first and then received enteral nutrition containing fortifier arginine through jejunum feeding tube. After treatment, the durations for the remission of abdominal signs, and the normalization of blood and urine amylase were compared between the two groups. Before treatment and after 14 days of treatment, the nutritional indices, humoral immune indices, cellular immune indices and inflammation indices were compared between the two groups. Results The durations for the remission of abdominal pain and abdominal distension, and the normalization of blood and urine amylase were shorter in the observation group compared to the control group （ P 〈 0.05 ）. After 14 days of treatment, the levels of serum albumin and prealbumin, IgA, IgG, IgM, total lymphocyte count, CD3 and CD4 increased in both groups（P 〈 0.05）, and the levels of these indices above in the observation group were higher than those in the control group（P 〈 0.05）. After 14 days of treatment, the levels of C reactive protein, tumor necrosis factor-ct, interleukin-6 decreased in both groups（ P 〈 0.05）, the levels of these indices above in the observation group were lower than those in the control group （ P 〈 0.05 ）. Conclusion For the patients with HAP, enteral nutrition containing fortifier arginine can more effectively relieve clinical symptoms,improve the nutrition condition and immunological function ,reduce the inflammation reaction during the acute period, thus can improve the prognosis and clinical efficacy.
出处
《广西医学》
CAS
2016年第12期1711-1714,共4页
Guangxi Medical Journal
关键词
高脂血症性急性胰腺炎
肠内营养
精氨酸
营养指标
免疫功能
炎症反应
Hyperlipidemic acute pancreatitis, Enteral nutrition,Arginine, Nutrition index, Immunologic function, Inflammation response
