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目的观察早期肠内营养联合微生态制剂治疗老年重症急性胰腺炎(SAP)的疗效。方法老年SAP患者60例均分为三组:A组采用早期肠内营养,1000~1500ml/d;B组早期肠内营养加用枯草杆菌2g口服,每天2次;C组实施肠外营养治疗。观察治疗前及治疗1周后营养蛋白水平、炎症指标TNF-α、IL-6和C反应蛋白(CRP)水平,并比较三组住院时间和并发症发生情况。结果治疗1周后,B组总蛋白较治疗前升高(P<0.05),A、B组前白蛋白水平均高于C组(P<0.05),三组IL-6、TNF-α和CRP均得到改善(P<0.05),B组改善较A组更明显(P<0.05)。A、B组多器官功能衰竭及胰周感染例数均少于C组(P<0.05)。A、B组住院时间均短于C组(P<0.05)。结论早期肠内营养联合微生态制剂治疗老年SAP可抑制炎症反应,减少并发症发生,并且能缩短住院时间。
Objective To observe the efficacy of early enteral nutrition combined with probiotics in the treatment of senile severe acute pancreatitis (SAP). Methods 60 elderly patients with SAP were divided into three groups: group A with early enteral nutrition, 1000 ~ 1500ml / d; group B early enteral nutrition plus 2g subtilis 2g twice daily; group C parenteral nutrition . The levels of nutritional protein and the levels of TNF-α, IL-6 and C-reactive protein (CRP) were observed before treatment and one week after treatment. The duration of hospitalization and complications were compared among the three groups. Results After treatment for 1 week, the total protein in group B was significantly higher than that before treatment (P <0.05), and the albumin levels in group A and B were higher than those in group C (P <0.05). The levels of IL-6, TNF- CRP were improved (P <0.05), and the improvement in group B was more obvious than that in group A (P <0.05). The number of multiple organ failure and peripancreatic infection in group A and group B were less than those in group C (P <0.05). The hospitalization time in group A and B were shorter than that in group C (P <0.05). Conclusion Early enteral nutrition combined with probiotics in the treatment of elderly SAP can inhibit the inflammatory response, reduce the incidence of complications, and can shorten the length of stay.