Duerksen D R, Bector S, Parry D, Yaffe C, Vajcner A, Lipschitz J
Department of Medicine, University of Manitoba, Winnipeg, Canada.
JPEN J Parenter Enteral Nutr. 2002 May-Jun;26(3):205-8. doi: 10.1177/0148607102026003205.
There are few studies examining the effect of jejunal feeding on pancreatic exocrine output. The purpose of this study was to compare the effects of jejunal feeding with an elemental formula (EF) and with a polymeric immune-enhancing formula (PIEF) on pancreatic exocrine function.
Patients undergoing a partial pancreatectomy had a jejunal feeding tube inserted and a pancreatic stent exteriorized, facilitating collection of pancreatic secretions. Postoperatively, patients underwent a secretin-stimulation test to document adequate pancreatic reserve. Patients were then randomized to receive jejunal feeding with EF or with PIEF for a 24-hour period, followed by a washout period of feeding with dextrose, and subsequent jejunal feeding with EF or PIEF.
The secretin-stimulation test demonstrated significant pancreatic reserve in all patients. There was a mild increase in pancreatic exocrine secretion with jejunal feeding with EF and PIEF compared with baseline and with dextrose. There was increased bicarbonate secretion with EF compared with PIEF, but there were no other significant differences in pancreatic exocrine function.
In this model of partial pancreatectomy, there was no significant difference in pancreatic exocrine output when use of an EF was compared with use of a PIEF for jejunal feeding. Further clinical studies are needed to determine the potential role of PIEF in pancreatic disease.
很少有研究探讨空肠喂养对胰腺外分泌的影响。本研究的目的是比较使用要素膳（EF）和聚合型免疫增强膳（PIEF）进行空肠喂养对胰腺外分泌功能的影响。
接受部分胰腺切除术的患者插入空肠喂养管并外置胰腺支架，以利于收集胰腺分泌物。术后，患者接受促胰液素刺激试验以证明有足够的胰腺储备。然后将患者随机分为接受EF或PIEF空肠喂养24小时，随后是葡萄糖冲洗期，接着再次接受EF或PIEF空肠喂养。
促胰液素刺激试验表明所有患者均有显著的胰腺储备。与基线和葡萄糖喂养相比，使用EF和PIEF进行空肠喂养时胰腺外分泌略有增加。与PIEF相比，EF喂养时碳酸氢盐分泌增加，但胰腺外分泌功能无其他显著差异。
在该部分胰腺切除模型中，使用EF与PIEF进行空肠喂养时，胰腺外分泌量无显著差异。需要进一步的临床研究来确定PIEF在胰腺疾病中的潜在作用。
