CAJ | 학술논문

目的：探讨早期肠内营养对急性重症胰腺炎患者炎症介质、营养指标及临床恢复的影响。方法2006年1月至2010年3月收治的急性重症胰腺炎患者患者59例，随机分成早期肠内营养组31例，肠外营养组28例，观察上述两组治疗后1、3、7天血清中TNF-α、IL-1β、前白蛋白、清蛋白的水平；外周血淋巴细胞数；并观察两组血清淀粉酶恢复时间，全身炎性反应综合征（ Systemic infammactery response syndrome ，SIRS）、腹腔脓肿及肝功能异常例数，治疗费用等指标的差异。结果早期肠内营养组治疗后3、7天血清TN F-α、IL-1β浓度明显低于肠外营养组（ P＜0．05），前白蛋白、清蛋白的水平、外周血淋巴细胞数明显高于肠外营养组（P＜0．05），治疗费用低于肠外营养组（P＜0．05），两组血清淀粉酶恢复时间，SIRS、腹腔脓肿及肝功能异常例数无明显差异（P＞0．05）。结论早期肠内营养在改善急性重症胰腺炎患者营养状态方面明显优于肠外营养，有利于提高机体的抗感染能力和各系统机能的恢复，是可靠、安全、经济的营养支持手段。
목적：탐토조기장내영양대급성중증이선염환자염증개질、영양지표급림상회복적영향。방법2006년1월지2010년3월수치적급성중증이선염환자환자59례，수궤분성조기장내영양조31례，장외영양조28례，관찰상술량조치료후1、3、7천혈청중TNF-α、IL-1β、전백단백、청단백적수평；외주혈림파세포수；병관찰량조혈청정분매회복시간，전신염성반응종합정（ Systemic infammactery response syndrome ，SIRS）、복강농종급간공능이상례수，치료비용등지표적차이。결과조기장내영양조치료후3、7천혈청TN F-α、IL-1β농도명현저우장외영양조（ P＜0．05），전백단백、청단백적수평、외주혈림파세포수명현고우장외영양조（P＜0．05），치료비용저우장외영양조（P＜0．05），량조혈청정분매회복시간，SIRS、복강농종급간공능이상례수무명현차이（P＞0．05）。결론조기장내영양재개선급성중증이선염환자영양상태방면명현우우장외영양，유리우제고궤체적항감염능력화각계통궤능적회복，시가고、안전、경제적영양지지수단。
Objective To investigate the effects of early enteral nutrition on inflammatory mediators , nutritional indicators and clinical recovery in patients with severe acute pancreatitis .Method 59 patients with severe acute pancreatitis admitted to the hospital from January ,2006 to March,2010 were randomly divided into two groups .31 cases were chosen as the early enteral nutrition group and 28 cases were chosen as the parenteral nutrition group .Differences of Serum TN F-α, IL-1β, prealbumin, albumin levels after 1,3,7 days treatment were observed and peripheral blood lymphocytes , recovery time of serum AMY, patient cases of SIRS, abdominal abscess and liver dysfunction , and treatment costs in both groups were recorded.Findings Findings serum TN F-α, IL-1βconcentration after 3, 7 days treatment in early enteral nutrition group was significantly lower than those of the parenteral nutrition group (P <0.05).prealbumin, albumin level, and thenumber of peripheral blood lymphocytes was significantly higher than those of the parenteral nutrition group (P <0.05).The treatment costs was less than that of the parenteral nutrition group (P <0.05).The recovery time of serum AMY,cases of SIRS , abdominal abscess, and liver function abnormalities were not significant (P >0.05).Conclusion Earlyenteral nutrition in improving the nutritional status of patients with severe acute pancreatitis was superior to parenteralnutrition.It can help to improve the body's resistance to infection and functional recovery .Therefore, it can serve as a safeand economical means of nutritional support way .