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1.电子科技大学医学院附属妇女儿童医院/成都市妇女儿童中心医院药学部,成都 611731
2.江苏省人民医院胰腺中心,南京 210029
3.江苏省人民医院药学部,南京 210029
主管药师,硕士。研究方向:临床药学。E-mail:84646975@qq.com
主管药师。研究方向:临床药学。E-mail:nanjingwudi@126.com
纸质出版日期:2023-12-30,
收稿日期:2023-08-10,
修回日期:2023-11-23,
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陈旭,邓毅,李强等.不同肠内营养制剂用于重症急性胰腺炎的疗效及胃肠道耐受性研究 Δ[J].中国药房,2023,34(24):3046-3050.
CHEN Xu,DENG Yi,LI Qiang,et al.Efficacy of different enteral nutrition drugs for severe acute pancreatitis and their gastrointestinal tolerance[J].ZHONGGUO YAOFANG,2023,34(24):3046-3050.
陈旭,邓毅,李强等.不同肠内营养制剂用于重症急性胰腺炎的疗效及胃肠道耐受性研究 Δ[J].中国药房,2023,34(24):3046-3050. DOI: 10.6039/j.issn.1001-0408.2023.24.16.
CHEN Xu,DENG Yi,LI Qiang,et al.Efficacy of different enteral nutrition drugs for severe acute pancreatitis and their gastrointestinal tolerance[J].ZHONGGUO YAOFANG,2023,34(24):3046-3050. DOI: 10.6039/j.issn.1001-0408.2023.24.16.
目的
2
比较不同肠内营养(EN)制剂用于重症急性胰腺炎(SAP)患者的疗效和胃肠道耐受性。
方法
2
收集2022年1月1日-2023年6月30日于江苏省人民医院胰腺中心住院治疗的118例SAP患者的临床资料,按使用EN制剂的不同分为短肽类EN制剂(SP)组(41例)、不含膳食纤维的整蛋白EN制剂(TP-MCT)组(40例)和含膳食纤维的整蛋白EN制剂(TPF-DM)组(37例)。3组患者均鼻饲24 h连续泵注EN制剂,能量目标量均为25~30 kcal/kg。收集3组患者用药前和用药7 d后的血液营养指标[白蛋白(ALB)、总蛋白(TP)、血红蛋白(Hb)、球蛋白(GLB)]和炎症指标[白细胞(WBC)、中性粒细胞百分比(N%)、降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素6(IL-6)],并汇总其临床结局指标[入住重症监护室(ICU)时间、住院时长、恢复经口饮食时长、病情未好转率、死亡率]及胃肠道耐受情况。
结果
2
用药后,3组患者的ALB、TP均显著高于同组用药前(
P
<0.05);3组患者的CRP、N%,TP-MCT组患者的PCT和SP组患者的IL-6均显著低于同组用药前,且TP-MCT组的PCT和SP组的IL-6均显著低于同期的其他两组(
P
<0.05);3组间用药后ALB、TP、CRP、N%比较及3组用药前后的Hb、GLB、WBC比较,差异均无统计学意义(
P
>0.05)。3组患者的临床结局指标比较,差异均无统计学意义(
P
>0.05)。TP-MCT组患者的胃肠道总不良反应发生率最低(32.50%),且显著低于SP组(46.34%)和TPF-DM(48.65%)(
P
<0.05)。
结论
2
不同EN制剂均能不同程度地改善SAP患者的营养状态并降低炎症反应,其中SP和TP-MCT的疗效较显著,且后者的胃肠道耐受性较好。
OBJECTIVE
2
To compare the efficacy of different enteral nutrition (EN) drugs for severe acute pancreatitis (SAP) and their gastrointestinal tolerance.
METHODS
2
A total of 118 SAP patients admitted to the Pancreatic Center of Jiangsu Provincial People’s Hospital from January 1, 2022 to June 30, 2023 were collected and divided into short-peptide EN drugs (SP) group (41 cases), dietary fiber-free intact protein EN drugs (TP-MCT) group (40 cases) and dietary fiber-containing intact protein EN drugs (TPF-DM) group (37 cases) according to the types of EN. All three groups of patients were given continuous pumps of EN drugs via nasal feeding for 24 hours, with a target energy dose of 25-30 kcal/kg. The blood nutritional indexes [albumin (ALB), total protein (TP), hemoglobin (Hb), globulin (GLB)], inflammation indexes [white blood cells (WBC), percentage of neutrophils (N%), procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)], clinical outcomes indexes [time of stay in the intensive care unit (ICU), length of hospital stay, duration of resuming oral diet, the rate of cases without improvement, mortality rate] and the occurrence of gastrointestinal tolerance were collected from 3 groups before medication and 7 d after medication.
RESULTS
2
After treatment, ALB and TP in 3 groups were significantly higher than before treatment (
P
<0.05); CRP and N% of 3 groups, PCT of TP-MCT group and IL-6 of SP group were significantly lower than corresponding group before medication (
P
<0.05); PCT of TP-MCT group and IL-6 of SP group were significantly lower than those of other two groups at corresponding period (
P
<0.05). There were no statistical significances in ALB, TP, CRP or N% among the three groups after medication, and in Hb, GLB or WBC among the three groups before and after treatment (
P
>0.05). There was no significant difference in clinical outcome indexes among 3 groups (
P
>0.05). The incidence of gastrointestinal adverse reactions in the TP-MCT group was the lowest (32.50%), and significantly lower than those in the SP group (46.34%) and TPF-DM group (48.65%) (
P
<0.05).
CONCLUSIONS
2
Different EN preparations can improve the nutritional status and reduce the inflammatory response in SAP patients to different extents, among which SP and TP-MCT are more effective, and TP-MCT shows the better gastrointestinal tolerance.
肠内营养重症急性胰腺炎疗效耐受性不良反应
severe acute pancreatitistherapeutic efficacytoleranceadverse reaction
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