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早期肠内营养干预对重症急性胰腺炎患者肠道菌群与感染的影响
作者:邢斌瑜 谭文君 申存毅 杨勤玲 
单位:(西安交通大学第一附属医院肝胆外科 西安 710061) 
关键词:重症急性胰腺炎 早期肠内营养 肠道菌群 
分类号:R730
出版年,卷(期):页码:2019,47(8):608-611
摘要:

目的 给予重症急性胰腺炎患者开展早期肠内营养干预,探究干预前后不同时间点肠道菌群与感染情况。方法 选取西安交通大学第一附属医院肝胆外科于2017年7月至2018年12月收治的重症急性胰腺炎患者75例,根据营养支持方式分为肠外组(37例)和肠内组(38例),比较干预前、营养支持后7 d两组营养情况、肠道菌群情况及感染发生率。结果 干预前,两组患者血清白蛋白、前白蛋白含量相近(P>0.05);营养支持7 d后,肠内组血清白蛋白、前白蛋白含量均明显高于肠外组(P<0.05),且两组患者前白蛋白含量较营养支持前均改善(P<0.05);两组患者营养支持前,肠道各菌群水平相近(P>0.05);营养支持7 d后,肠内组双歧杆菌、乳酸杆菌和肠球菌水平均优于营养支持前,且优于肠外组(P<0.05);肠内组患者感染发生率为5.26%,肠外组感染发生率为24.32%,肠内组明显低于肠外组(P<0.05)。结论 给予重症胰腺炎患者开展早期肠内营养干预,可提升营养情况,改善肠道菌群并降低继发性感染发生率,干预具有明显优势。

Objective To provide early enteral nutrition intervention to patients with severe acute pancreatitis,so as to explore the intestinal flora and infection at different time points before and after intervention.Methods 75 patients with severe acute pancreatitis admitted to the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi’an Jiaotong University from July 2017 to December 2018 were selected,and then they were divided into parenteral group(37 cases) and enteral group(38 cases) according to the way of nutritional support.The nutritional status,intestinal flora and infection rate of the two groups were compared before intervention and 7 days after nutritional support.Results Before intervention,the serum albumin and prealbumin contents in the two groups were similar(P>0.05).After 7 days of nutritional support,the contents of serum albumin and prealbumin in the enteral group were significantly higher than those in the parenteral group(P<0.05),and the contents of prealbumin in both groups were improved compared with those before nutritional support(P<0.05).Before nutritional support,the intestinal flora levels of the two groups were similar(P>0.05).After 7 days of nutritional support,however,the levels of Bifidobacterium,Lactobacillus and Enterococcus in the enteral group were better than those before nutritional support,and better than those in the parenteral group(P<0.05).The incidence of infection was 5.26% in the enteral group and 24.32% in the parenteral group,and the incidence of infection in the enteral group was significantly lower than that in the parenteral group(P<0.05).Conclusion Early enteral nutrition intervention for patients with severe pancreatitis can improve nutritional status,improve intestinal flora and reduce the incidence of secondary infection,which has obvious advantages.

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