CAJ | 학술논문

目的探讨早期肠内营养在重症急性胰腺炎(SAP)治疗中的安全性和有效性.方法回顾性分析71例SAP患者临床资料,经综合治疗观察患者血清白蛋白、前白蛋白、TNF-α、CD4/CD8、IgG水平.随机分为肠内营养组(EN组,36例)和全肠外营养组(11PN组,35例).结果 EN组治疗后14 d患者血清CD4/CD8及IgC水平比TPN组明显升高(P＜0.05);EN组治疗后7、14 d时TNF-α水平与治疗前比较明显下降(P＜0.05),且与TPN组比较明显减少(P＜0.05);EN组治疗后血清前白蛋白水平较治疗前明显增高(P＜0.05),且与TPN组比较亦有显著性增高(P＜0.05).结论早期肠内营养对SAP治疗是安全、有效的,可提高血清前白蛋白水平,改善其营养状况,增强肠道黏膜屏障,抑制炎性因子释放,增强患者的免疫功能,改善SAP的预后.
목적 탐토조기장내영양재중증급성이선염(SAP)치료중적안전성화유효성.방법 회고성분석71례SAP환자림상자료,경종합치료관찰환자혈청백단백、전백단백、TNF-α、CD4/CD8、IgG수평.수궤분위장내영양조(EN조,36례)화전장외영양조(11PN조,35례).결과 EN조치료후14 d환자혈청CD4/CD8급IgC수평비TPN조명현승고(P＜0.05);EN조치료후7、14 d시TNF-α수평여치료전비교명현하강(P＜0.05),차여TPN조비교명현감소(P＜0.05);EN조치료후혈청전백단백수평교치료전명현증고(P＜0.05),차여TPN조비교역유현저성증고(P＜0.05).결론 조기장내영양대SAP치료시안전、유효적,가제고혈청전백단백수평,개선기영양상황,증강장도점막병장,억제염성인자석방,증강환자적면역공능,개선SAP적예후.
Objective To appraise the safety and validity of early enteral nutrition on the course on treating severe acute pancreatitis(SAP).Methods The clinical data of 71 patients with SAP were analyzed retrospectively. The album, prealbumin, TNF-β,CD4/CD8,IgG were observed. All the patients were randomly divided into two groups: enteral nutrition(EN)group for 36 patients and total parenteral nutrition(TPN)group for 35 patients. Results Fourteen days after treatment,CD4/CD8 and IgG in EN group were significantly increased than those in TPN group(P＜0.05),and prealbumin level in EN group significantly elevated(P＜0.05)and was higher than that in TPN group(P＜0.05).After treatment,TNF-α level in EN group significantly depressed(P＜0.05)and was lower than that in TPN group(P＜0.05).Conclusion Early enteral nutrition is safe and valid, and can promote albumin synthesis and prealbumin levels to improve their nutrition in patients with SAP, and may build-up the barrier of enteric mucosa to prevent bacterial shift, reduce systemic inflammatory reaction and improve its prognosis.