[1]洪伟煊,王梅平,肖春红,等.合生元联合谷氨酰胺对重症急性胰腺炎病人行早期肠内营养耐受性及营养状况的影响[J].肠外与肠内营养杂志,2022,(02):85-88.[doi:10.16151/j.1007-810x.2022.02.005]
 HONG Wei-xuan,WANG Mei-ping,XIAO Chun-hong,et al.Effect of synbionics combined with glutamine on early enteral nutrition tolerance and nutritional status in patients with severe acute pancreatitis[J].PARENTERAL & ENTERAL NUTRITION,2022,(02):85-88.[doi:10.16151/j.1007-810x.2022.02.005]
点击复制

合生元联合谷氨酰胺对重症急性胰腺炎病人行早期肠内营养耐受性及营养状况的影响
分享到:

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2022年02期
页码:
85-88
栏目:
论著
出版日期:
2022-03-10

文章信息/Info

Title:
Effect of synbionics combined with glutamine on early enteral nutrition tolerance and nutritional status in patients with severe acute pancreatitis
作者:
洪伟煊王梅平肖春红张再重祁亚峰王 烈
福建中医药大学福总教学医院/联勤保障部队第九〇〇医院普通外科,福建福州 350025
Author(s):
HONG Wei-xuan WANG Mei-ping XIAO Chun-hong ZHANG Zai-zhong QI Ya-feng WANG Lie
Department of General Surgery, Clinical Teaching Hospital of Fujian University of Traditional Chinese Medicine /the 900th Hospital of The Joint Logistics Support Force of Chinese PLA, Fuzhou 350025, Fujian, China
关键词:
重症急性胰腺炎 合生元 谷氨酰胺 肠内营养
Keywords:
Acute pancreatitis Synbiotic Glutamine Enteral nutrition
分类号:
R576
DOI:
10.16151/j.1007-810x.2022.02.005
文献标志码:
A
摘要:
目的:探讨合生元制剂联合谷氨酰胺对重症急性胰腺炎(SAP)病人行早期肠内营养(EEN)肠道耐受性及营养状况的影响。 方法:前瞻性选取2020年1月至2021年6月,联勤保障部队第九〇〇医院普通外科收治的78例SAP病人为研究对象,随机分为对照组(n = 39)与实验组(n = 39)。入院24 ~ 48 h内置入鼻空肠管进行EEN治疗。对照组给予含谷氨酰胺的肠内营养混悬液,实验组在前者基础上给予合生元制剂(双歧杆菌三联活菌+蔗果低聚糖)。比较两组病人干预后的每日胃排空情况(胃残余量),干预7 d后肠内营养喂养不耐受症状、营养指标[血清运铁蛋白(TF)、白蛋白(ALB)、前白蛋白(PA)]。 结果:干预后,实验组每日胃排空情况明显优于对照组,差异有统计学意义(P < 0.05)。干预7 d后,实验组腹胀、腹痛、腹泻发生率显著低于对照组,差异有统计学意义(P < 0.05),而恶心、呕吐发生率与对照组比较无统计学意义(P > 0.05)。两组营养状况指标较干预前均有明显提升,且实验组 干预后明显高于对照组,差异有统计学意义(P < 0.05)。 结论:给予合生元制剂联合谷氨酰胺的肠内营养混悬液能够有效提高SAP病人EEN耐受性,改善其营养状况。
Abstract:
Objective: To investigate the effect of synbionic combined with glutamine on the tolerance of early enteral nutrition (EN) and nutritional status in patients with severe acute pancreatitis (SAP). Methods: A total of 78 SAP patients from January 2020 to June 2021 were included in the study and were randomized into control groups (n = 39) and experimental groups (n = 39). Feeding pathway with nasogastric tube was established and early EN treatment was initiated within 24 ~ 48 hours after admission. Patients in the control group was treated with glutamine-containing enteral nutrient suspension whereas those in the experimental group was treated with synbiotic preparation (triple viable bifidobacterium + sucrose oligosaccharides) and enteral nutrition. The gastric residual volumes in both groups were estimated every day. Symptoms of enteral feeding intolerance and nutritional status (serum ferritin, albumin, proalbumin) were observed 7 days after treatment. Results: The daily gastric residue volumes in the experimental group were significantly lower than that in the control group (P < 0.05). After 7 days of treatment, the incidence of bloating, abdominal pain and diarrhea in the experimental group was significantly lower than those in the control group (P < 0.05), while the incidence of nausea and vomiting was similar between the two groups (P > 0.05). The nutritional status of both groups were improved after nutritional intervention (P < 0.05). Nutritional outcome after nutrition support in the experimental group was better than that in the control group (P < 0.05). Conclusion: Symbiotic combined with glutamine is associated with lower intolerance after early EN and improves the nutritional status in patients with SAP.

参考文献/References:


[1] Hongyin L, Zhu H, Tao W, et al. Abdominal paracentesis drainage improves tolerance of enteral nutrition in acute pancreatitis: a randomized controlled trial. Scand J Gastroenterol, 2017, 52 (4):389-395.
[2] Li XY, He C, Zhu Y, et al. Role of gut microbiota on intestinal barrier function in acute pancreatitis. World J Gastroenterol,2020, 26 (18): 2187-2193.
[3] Takauji S, Konishi H, Fujiya M, et al. Polyphosphate, Derived from Lactobacillus brevis, Modulates the Intestinal Microbiome and Attenuates Acute Pancreatitis. Dig Dis Sci, 2021, 66 (11):3872-3884.
[4] Li C, Liu L, Gao Z, et al. Synbiotic Therapy Prevents Nosocomial Infection in Critically Ill Adult Patients: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Based on a Bayesian Framework. Front Med (Lausanne), 2021, 8:693188.
[5] Yu C, Zhang Y, Yang Q, et al. An Updated Systematic Review With Meta-analysis: Efficacy of Prebiotic, Probiotic, and Synbiotic Treatment of Patients With Severe Acute Pancreatitis. Pancreas, 2021, 50 (2): 160-166.
[6] Jablonska B, Mrowiec S. Nutritional Support in Patients with Severe Acute Pancreatitis-Current Standards. Nutrients, 2021, 13(5): 1498.
[7] 中华医学会消化病学分会胰腺疾病学组. 中国急性胰腺炎诊治指南(2019,沈阳). 中华胰腺病杂志, 2019, 19(5): 321-331.
[8] Pan LL, Li J, Shamoon M, et al. Recent Advances on Nutrition in Treatment of Acute Pancreatitis. Front Immunol, 2018, 9: 849.
[9] Gomes CA, Di Saverio S, Sartelli M, et al. Severe acute pancreatitis: eight fundamental steps revised according to the 'PANCREAS' acronym. Ann R Coll Surg Engl, 2020, 102 (8): 555-559.
[10] 张 伟, 鲍 峰. 不同时期微生态肠内营养对急性重症胰腺炎患者全身炎症反应、细菌移位以及免疫功能的影响. 解放军预防医学杂志, 2020, 38 (10): 151-154, 158.
[11] Patel BK, Patel KH, Bhatia M, et al. Gut microbiome in acute pancreatitis: A review based on current literature. World J Gastroenterol, 2021, 27 (30): 5019-5036.
[12] 童智慧, 李维勤, 虞文魁, 等. 早期肠内营养添加谷氨酰胺对重症急性胰腺炎炎症反应和免疫功能的影响. 肠外与肠内营养,2009, 16 (05): 264-268.
[13] Jafari T, Feizi A, Askari G, et al. Parenteral immunonutrition in patients with acute pancreatitis: a systematic review and meta analysis. Clin Nutr, 2015, 34 (1): 35-43.
[14] Lutgendorff F, Nijmeijer RM, Sandstrom PA, et al. Probiotics prevent intestinal barrier dysfunction in acute pancreatitis in rats via induction of ileal mucosal glutathione biosynthesis. PLoS One,2009, 4 (2): e4512.
[15] Tian X, Pi YP, Liu XL, et al. Supplemented Use of Pre-, Pro-, and Synbiotics in Severe Acute Pancreatitis: An Updated Systematic Review and Meta-Analysis of 13 Randomized Controlled Trials. Front Pharmacol, 2018, 9: 690.
[16] 乔晓萍, 蔡东联, 耿珊珊, 等. 益生菌(元)联合肠内营养对重症急性胰腺炎大鼠肠道屏障功能的影响. 肠外与肠内营养, 2007,14(06): 330-333.

相似文献/References:

[1]张再重,肖春红,宋京翔,等.足三里穴位注射新斯的明改善重症急性胰腺炎早期肠内营养耐受性[J].肠外与肠内营养杂志,2020,(01):12.[doi:10.16151/j.1007-810x.2020.01.004]
 ZHANG Zai-zhong,XIAO Chun-hong,SONG Jing-xiang,et al.Effect of Zusanli acupoint injection on early enteral nutrition tolerance in patients with severe acute pancreatitis[J].PARENTERAL & ENTERAL NUTRITION,2020,(02):12.[doi:10.16151/j.1007-810x.2020.01.004]
[2]黄其密,肖 莉,何 伟,等.盲插空肠营养管在重症急性胰腺炎病人中 应用的临床效果评价[J].肠外与肠内营养杂志,2020,(03):171.[doi:DOI : 10.16151/j.1007-810x.2020.03.010 ]
 HUANG Qi-mi,XIAO Li,HE Wei,et al.The clinical effect of blind insertion of jejunum nutrient tube in the patients with severe acute pancreatitis[J].PARENTERAL & ENTERAL NUTRITION,2020,(02):171.[doi:DOI : 10.16151/j.1007-810x.2020.03.010 ]
[3]李百强,武之洋,袁晨晨,等.鱼油代谢物保护素D1对重症急性胰腺炎小鼠肠粘膜损伤保护作用的研究[J].肠外与肠内营养杂志,2020,(04):205.[doi:10.16151/j.1007-810x.2020.04.004]
 LI Bai-qiang,WU Zhi-yang,YUAN Chen-chen,et al.Protective effect of protectin D1 inhibitor on intestinal mucosal injury in mice with severe acute pancreatitis[J].PARENTERAL & ENTERAL NUTRITION,2020,(02):205.[doi:10.16151/j.1007-810x.2020.04.004]
[4]赵晓璠,唐 春,何 琴,等.高通量测序检测重症急性胰腺炎病人外周血细菌DNA谱[J].肠外与肠内营养杂志,2021,(03):152.[doi:10.16151/j.1007-810x.2021.03.006]
 ZHAO Xiao-Fan,TANG Chun,HE Qin,et al.Characterization of blood bacterial DNA profiles in patients with severe acute pancreatitis using next-generation sequencing[J].PARENTERAL & ENTERAL NUTRITION,2021,(02):152.[doi:10.16151/j.1007-810x.2021.03.006]
[5]黄彩云,石 萍,李 娜,等.重症急性胰腺炎腹腔高压对旋转推进法留置鼻肠管成功率影响[J].肠外与肠内营养杂志,2021,(03):167.[doi:10.16151/j.1007-810x.2021.03.009]
 HUANG Cai-yun,SHI Ping,LI Na,et al.The impact of severe acute pancreatitis with intra-abdominal hypertension on the success rate of placing nasojejunal tube by rotating advance method[J].PARENTERAL & ENTERAL NUTRITION,2021,(02):167.[doi:10.16151/j.1007-810x.2021.03.009]
[6]王杏宝,田 佳,陈业雄.外源性 P-MSCs 移植对 SAP 大鼠小肠屏障功能的保护作用[J].肠外与肠内营养杂志,2022,(03):155.[doi:DOI : 10.16151/j.1007-810x.2022.03.006]
 WANG Xing-bao,TIAN Jia,CHEN Ye-xiong.Protective effects of exogenous P-MSCs transplantation on intestinal barrier function in severe acute pancreatitis rats[J].PARENTERAL & ENTERAL NUTRITION,2022,(02):155.[doi:DOI : 10.16151/j.1007-810x.2022.03.006]

备注/Memo

备注/Memo:
基金项目 :福建省自然科学基金面上项目(2020J01113&2021J011262);联勤保障部队第九〇〇医院院内课题(2020L01&2020L26&2021MS24) 作者简介 :洪伟煊,住院医师,医学硕士,从事普通外科疾病临床与基础研究。E-mail:weixuan.hong@aliyun.com 共同第一作者:王梅平,主治医师,医学硕士,从事普通外科疾病临床与基础研究。E-mail:12281982@qq.com 通讯作者 :王 烈,E-mail:fzptwk@126.com
更新日期/Last Update: 1900-01-01