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区域动脉灌注联合早期肠内营养对重症急性胰腺炎的影响。

Effect of regional arterial infusion combined with early enteral nutrition on severe acute pancreatitis.

作者信息

Wang Xiaojuan, Xu Jinbu, Li Jiguang, Cheng Yajuan, Liu Lu, Du Zhiqiang

机构信息

Intensive Care Unit, the Second People's Hospital of Lianyungang, Lianyungang, Jiangsu Province, China.

Intensive Care Unit, the First People's Hospital of Lianyungang, Lianyungang, Jiangsu Province, China.

出版信息

J Int Med Res. 2019 Dec;47(12):6235-6243. doi: 10.1177/0300060519880760. Epub 2019 Oct 30.

Abstract

OBJECTIVE

To measure the therapeutic effects of regional arterial infusion (RAI) in combination with early enteral nutrition (EEN) in patients with severe acute pancreatitis (SAP).

METHODS

A prospective randomized controlled study enrolled patients with SAP. They were randomly divided into a conventional treatment group that served as the control and a combination therapy group that received RAI combined with EEN. The Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) scores, the levels of serum biochemical indices, functional recovery, the incidence of complications and total effectiveness rate were evaluated.

RESULTS

A total of 100 patients were enrolled in the study. The APACHE II scores and the concentrations of blood glucose, serum amylase, white blood cell count, C-reactive protein, tumour necrosis factor-α, interleukin (IL)-6, IL-10 and IL-17 were significantly decreased, while albumin and serum calcium and total effectiveness rate in the combination therapy group were significantly higher than in the conventional treatment group. The combination therapy group had a significantly reduced time to abdominal pain relief, time of first defaecation, hospital stay and incidence of complications compared with the conventional treatment group.

CONCLUSION

The combination of RAI and EEN improved clinical biochemical indices, reduced the incidence of complications and promoted early recovery in patients with SAP.

摘要

目的

探讨区域动脉灌注(RAI)联合早期肠内营养(EEN)对重症急性胰腺炎(SAP)患者的治疗效果。

方法

采用前瞻性随机对照研究,纳入SAP患者。将其随机分为作为对照组的传统治疗组和接受RAI联合EEN的联合治疗组。评估急性生理与慢性健康状况评分系统II(APACHE II)评分、血清生化指标水平、功能恢复情况、并发症发生率及总有效率。

结果

共纳入100例患者。联合治疗组的APACHE II评分、血糖、血清淀粉酶、白细胞计数、C反应蛋白、肿瘤坏死因子-α、白细胞介素(IL)-6、IL-10及IL-17浓度显著降低,而白蛋白、血清钙及总有效率显著高于传统治疗组。与传统治疗组相比,联合治疗组的腹痛缓解时间、首次排便时间、住院时间及并发症发生率显著缩短或降低。

结论

RAI联合EEN可改善SAP患者的临床生化指标,降低并发症发生率,促进患者早期康复。

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Severe acute pancreatitis: pathogenesis, diagnosis and surgical management.重症急性胰腺炎:发病机制、诊断及外科治疗
Hepatobiliary Pancreat Dis Int. 2017 Apr;16(2):155-159. doi: 10.1016/s1499-3872(16)60163-7.

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