肠内营养前输注氨基酸对急性胰腺炎患者胆汁淤积的影响

目的观察肠内营养前输注氨基酸对急性胰腺炎患者胆汁淤积的影响。方法将32例急性胰腺炎患者随机分为实验组和对照组，每组16例。对照组采用常规肠内营养治疗，实验组在肠内营养前给予静脉输注氨基酸。观察两组患者治疗前后APACHEⅡ评分的变化、肝功能指标的改变、胆囊收缩素（CCK）峰值水平及胆囊排空指数等指标。结果治疗后两组患者APACHEII评分均较治疗前显著改善，但实验组改善更为显著；对照组在治疗第3天时总胆红素（TB）和直接胆红素（DB）水平均较治疗前显著升高，治疗第7天时有所回落，而实验组患者TB和DB水平均在治疗第3、7天时有所降低；CCK检测显示实验组CCK峰值在治疗第3、7天时均显著优于对照组；实验组治疗第3、7天时胆囊排空率均显著高于对照组。结论在肠内营养前给予静脉输注氨基酸可增加CCK水平，增强患者胆囊排空能力，从而改善患者的胆汁淤积。

Effects of Injection of Amino Acids Before Enteral Nutrition on the Cholestasis of Patients with Acute Pancreatitis

Objective To observe the effects of injection of amino acids before enteral nutrition on the cholestasis of patients with acute pancreatitis. Methods Thirty-two patients with acute pancreatitis were equally and randomly divided into control group and experimental group. The patients in control group were given conventional enteral nutrition, while additional injection of amino acids before enteral nutrition was used in experimental group. The changes of APACHE II score, liver function indexes, cholecystokinin （CCK） peak and gallbladder emptying fraction were observed before and after treatment in two groups. Results The APACHE lI score in both groups improved notably after treatment, hut the effect in experimental group was more significant. The levels of total hilirubin （TB） and direct bilirubin （DB） increased significantly in control group on the treatment of 3rd day,and slightly decreased on the 7th day,however they decreased on the treatment of 3rd and 7th day in experimental group. Both CCK peak and gallbladder emptying fraction in experimental group were significantly higher than those in control group on the treatment of 3rd and 7th day. Conclusion Injection of amino acids before enteral nutrition can improve CCK level and enhance the ability of gallbladder emptying, so as to alleviate the cholestasis of patients with acute pancreatitis.