论文部分内容阅读
[目的]探讨不同方式营养支持对重症急性胰腺炎患者血浆内毒素水平的影响。[方法]采用单纯随机抽样方法将符合入选标准的47例重症急性胰腺炎患者随机分为肠内营养联合肠外营养组(PN+EN组,n=24)和完全肠外营养(TPN组,n=23)。两组病人接受同样的基础治疗,所有病人均于营养支持前及营养支持后d3、d7、d10检测血浆内毒素(LPS)浓度,并观察并发症发生情况。结果EN+PN组治疗后血浆内毒素水平较治疗前逐渐降低,而TPN组较治疗前逐渐增高。治疗d7和d10EN+PN组显著低于TPN组,且差异有统计学意义(P﹤0.01)。PN+EN组的并发症发生率低于TPN组,且腹胀和腹泻发生率显著降低(P﹤0.05)。[结论]早期肠内营养可维持肠道黏膜屏障功能,显著降低SAP患者血浆LPS浓度,减少并发症发生。
[Objective] To investigate the effects of different nutritional support on plasma endotoxin level in patients with severe acute pancreatitis. [Methods] Forty-seven patients with severe acute pancreatitis who met the inclusion criteria were randomly divided into three groups: enteral nutrition plus parenteral nutrition group (PN + EN group, n = 24) and total parenteral nutrition group n = 23). Both groups received the same basic treatment. All patients were tested for plasma endotoxin (LPS) concentrations before and after nutrition support at d3, d7 and d10, and complications were observed. Results The plasma endotoxin levels in EN + PN group decreased gradually after treatment, while TPN group increased gradually before treatment. The treatment of d7 and d10EN + PN group was significantly lower than the TPN group, and the difference was statistically significant (P <0.01). The incidence of complications in PN + EN group was lower than that in TPN group, and the incidence of abdominal distension and diarrhea was significantly decreased (P <0.05). [Conclusion] Early enteral nutrition can maintain the intestinal mucosal barrier function, significantly reduce the concentration of plasma LPS in SAP patients and reduce the incidence of complications.