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目的探讨益生元强化肠内营养(prebiotic fiber enriched enteral nutrition,PEN)与常规肠内营养(enteral nutrition,EN)对重症急性胰腺炎(severe acute pancreatitis,SAP)疗效的差异。方法自2013年8月至2015年6月按照连续采样的方法,收集确诊为SAP住院治疗的46例患者的临床资料。随机数字表法将患者随机分为PEN、EN两组,EN组接受常规早期肠内营养,PEN组在EN组营养配方的基础上添加益生元。比较两组患者总体住院时间、ICU入住时间、肠内营养支持时间、血淀粉酶/CRP/APACHEⅡ评分/CTSI评分恢复正常时间、并发症发生率、病死率及住院费用的差异。结果患者分组结果为PEN组25例,EN组21例。患者年龄分布,性别/病因构成,平均BMI,平均发病至入院时间,入院血淀粉酶、CRP、前白蛋白(prealbumin,PA)、入院APACHEⅡ/CTSI评分比较,组间无显著性差异(P>0,05)。患者临床经过及结局相比,PEN组患者住院时间、肠内营养支持治疗时间、APACHEⅡ评分恢复正常时间、CTSI评分恢复正常时间相对较短,并发症发生率相对较低,住院费用相对较少,组间差异有统计学意义(P均<0.05)。结论与传统肠内营养相比,益生元强化的肠内营养更有助于降低SAP患者的感染性并发症发生率和死亡率,加速患者康复,值得临床进一步研究探索。
Objective To investigate the effect of prebiotic fiber enriched enteral nutrition (PEN) and routine enteral nutrition (EN) on patients with severe acute pancreatitis (SAP). Methods From August 2013 to June 2015, the clinical data of 46 patients diagnosed as SAP hospitalized were collected according to the continuous sampling method. Patients were randomly divided into PEN and EN groups according to random number table method. EN group received routine early enteral nutrition, and PEN group added prebiotics based on the nutritional formula of EN group. The total hospital stay, ICU admission time, enteral nutrition support time, blood amylase / CRP / APACHE II score / CTSI score recovery time, complications, mortality and hospitalization costs were compared between the two groups. Results The results of the grouping were 25 in the PEN group and 21 in the EN group. There were no significant differences in age distribution, gender / etiology, mean BMI, mean onset to admission time, amylase admission, CRP, prealbumin (PA), APACHEⅡ / CTSI admission admission scores 0,05). Compared with the clinical outcome, the length of hospital stay, the duration of enteral nutrition support, the recovery time of APACHEⅡ, the relatively short recovery time of CTSI, the relatively low complication rate, relatively low hospitalization costs, The difference between the two groups was statistically significant (P <0.05). Conclusions Compared with traditional enteral nutrition, pre-enteral nutrition with prebiotics can help to reduce the incidence of infectious complications and mortality in patients with SAP and accelerate the recovery of patients. It is worth further exploration in the clinic.