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腹腔穿刺引流可提高急性胰腺炎患者肠内营养耐受性:一项随机对照试验

Abdominal paracentesis drainage improves tolerance of enteral nutrition in acute pancreatitis: a randomized controlled trial.

作者信息

Hongyin Liang, Zhu Huang, Tao Wang, Ning Lin, Weihui Liu, Jianfeng Cui, Hongtao Yan, Lijun Tang

机构信息

a Department of General Surgery , Chengdu Military General Hospital , Chengdu , Sichuan Province , China.

b Department of Postgraduate , Third Military Medical University , Chongqing , China.

出版信息

Scand J Gastroenterol. 2017 Apr;52(4):389-395. doi: 10.1080/00365521.2016.1276617. Epub 2017 Jan 4.

Abstract

OBJECTIVE

The objective of this study is to determine whether abdominal paracentesis drainage (APD) could improve the administration of enteral nutrition (EN) in acute pancreatitis.

METHODS

Between January 2015 and April 2016, a total of 161 acute pancreatitis patients were enrolled and randomly assigned to either the APD group or the non-APD group. Several indexes associated with the administration of EN, including the gastroparesis cardinal symptom index (GCSI), the incidence of gastrointestinal adverse events, and the clinical outcomes, were recorded.

RESULTS

The mean GCSI scores were 13.6 ± 2.1 before randomization and 7.1 ± 2.3 after a week in the APD group. These scores were 13.9 ± 2.4 and 9.7 ± 1.9 in the non-APD group. The incidences of gastrointestinal adverse events in the two groups were similar (p > .05), except for diarrhea. However, the patients in the APD group spent less time achieving the nutrition target (25 per kilogram of body weight per day) and fully tolerated the oral diet (p < .05). Additionally, the clinical outcomes of the APD group were better compared with those of the non-APD group.

CONCLUSION

APD can improve the administration of EN in acute pancreatitis. Given the positive effect of EN on clinical outcomes, this phenomenon possibly explains why APD could improve the clinical outcomes of acute pancreatitis patients in some aspects.

摘要

目的

本研究旨在确定腹腔穿刺引流(APD)是否能改善急性胰腺炎患者肠内营养(EN)的实施情况。

方法

2015年1月至2016年4月,共纳入161例急性胰腺炎患者,随机分为APD组和非APD组。记录与EN实施相关的几个指标,包括胃轻瘫主要症状指数(GCSI)、胃肠道不良事件的发生率和临床结局。

结果

APD组随机分组前的平均GCSI评分为13.6±2.1,一周后的评分为7.1±2.3。非APD组的这些评分分别为13.9±2.4和9.7±1.9。除腹泻外,两组胃肠道不良事件的发生率相似(p>0.05)。然而,APD组患者达到营养目标(每天每公斤体重25千卡)的时间更短,并且能完全耐受口服饮食(p<0.05)。此外,APD组的临床结局优于非APD组。

结论

APD可改善急性胰腺炎患者EN的实施情况。鉴于EN对临床结局有积极影响,这一现象可能解释了为什么APD能在某些方面改善急性胰腺炎患者的临床结局。

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