大黄联合早期肠内营养治疗重症急性胰腺炎的临床研究

目的:观察大黄联合早期肠内营养治疗重症急性胰腺炎(SAP)的疗效。方法:将64例SAP患者随机分为3组:全肠外营养(TPN)组20例,早期肠内营养(EEN)组23例和大黄联合早期肠内营养(REN)组21例。观察3组患者住院费用、住院时间、死亡人数、肠道功能恢复时间、A-PACHEⅡ评分、并发症,检测血浆降钙素原(PCT)、C-反应蛋白(CRP)、前白蛋白、CD3%、CD4%、CD8%、CD4/CD8、IgG、IgA及IgM并进行比较。结果:REN组无1例死亡,EEN组死亡1例,TPN组2例;REN组肠道功能恢复时间(2.6±0.7)d,平均住院天数(24±4)d,费用(5.5±0.7)万元,均低于其他两组(TPN组,P<0.01;EEN组,P<0.05)。治疗2周后REN组APACHE-II评分由11.8±2.4下降为3.1±1.0,CRP由(151.1±45.6)mg/L下降至(16.6±2.1)mg/L,PCT阳性例数由19例下降为2例(P<0.01),与其他两组比较,均下降更低(TPN组,P<0.01;EEN组,P<0.05)。REN组血前白蛋白由(121±9)升高为(315±21)mg/L(P<0.01),比TPN组上升更显著(P<0.01);REN组IgG、IgA、IgM、CD4%、CD3%、CD4/CD8均比其他两组上升更明显(TPN组,P<0.01;EEN组,P<0.05),而CD8%下降更显著(TPN组,P<0.01;EEN组,P<0.05)。结论:REN治疗SAP是有效的,促进消化道功能恢复,改善SAP患者营养和免疫状况,降低炎症反应,缩短住院时间,减少医疗费用,优于TPN及EEN。

Clinical research of rhubarb combining with early enteral nutrition on severe acute pancreatitis

AIM : To research the effects of rhubarb combining with early enteral nutrition on severe acute pancreatitis(SAP). METHODS : 64 patients with SAP were randomly received one of the three therapies below: 20 patients were treated with total parenteral nutrition(TPN),23 patients were treated with early enteral nutrition(EEN),and 21 patients were treated with rhubarb combining with early enteral nutrition(REN).The hospitalization cost,length of stay,mortality,recovery time of intestinal function and score of AP...