Effects of probiotics combined with early enteral nutrition on nutritional status, intestinal mucosal barrier function and enteral nutrition tolerance in patients with severe acute pancreatitis

doi:10.3877/cma.j.issn.2095-2015.2023.01.011

Abstract

Abstract:

Objective

To observe the effects of probiotics combined with early enteral nutrition on nutritional status, intestinal mucosal barrier function and enteral nutrition tolerance in patients with severe acute pancreatitis.

Methods

A total of 92 patients with severe acute pancreatitis who were admitted to Second People′s Hospital of Huai′an City from January 2020 to May 2021 were selected and divided into experimental group and control group according to the random number table method, with 46 cases in each group.Among them, the control group was treated with early enteral nutrition, and the experimental group was treated with probiotics combined with early enteral nutrition.The changes in the nutritional status, intestinal mucosal barrier function and enteral nutrition tolerance of the two groups were compared.

Results

After treatment, the nutritional indicators of serum albumin, prealbumin, transferrin, arm muscle circumferenc and triceps skinfold thickness of the experimental group were increased more than those of the control group.The total amount of lactobacillus, enterococcus, bifidobacterium and other beneficial bacteria in the experimental group was higher than that in the control group.The contents of D-lactic acid and diamine oxidase in intestinal mucosal barrier and plasma endotoxin levels in the the experimental group were lower than those in the control group.There were statistically significant differences(P<0.05). The improvement of intestinal flora and intestinal mucosal barrier in the experimental group was more ideal than that in the control group.

Conclusion

Probiotics combined with early enteral nutrition for treatment of patients with severe acute pancreatitis can achieve good curative effects.

Key words: Severe acute pancreatitis, Probiotics, Enteral nutrition, Intestinal barrier, Tolerance

Yingzhi Wang, Xianjin Zhang, Shiyan Yang. Effects of probiotics combined with early enteral nutrition on nutritional status, intestinal mucosal barrier function and enteral nutrition tolerance in patients with severe acute pancreatitis[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(01): 55-58.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2023.01.011

https://zhxhbyyxzz.cma-cmc.com.cn/EN/Y2023/V13/I01/55

Figures/Tables 4

References 18

1	殷诺铭，曾悦．重症急性胰腺炎中的肠道免疫与菌群紊乱[J]．中华胰腺病杂志，2021，21(3)：168-172.
2	Xiao Q，Lang L，Ma Z，et al.Exploration of the Curative Effect of Early Enteral Nutrition Nursing on Patients with Severe Acute Pancreatitis and the Improvement of Patients′ Mental Health and Inflammation Level[J]．J Healthc Eng，2021，2021：8784905.
3	宫雪梅，叶向红，薛阳阳，等．重症患者早期肠内营养耐受性评估及管理方案的构建[J]．中华护理杂志，2019，54(4)：490-494.
4	Ye S，Si C，Deng J，et al.Understanding the Effects of Metabolites on the Gut Microbiome and Severe Acute Pancreatitis[J]．Biomed Res Int，2021，2021：1516855.
5	孙备．再认识外科医师在治疗重症急性胰腺炎中的作用与价值[J/OL]．中华普通外科学文献(电子版)，2020，14(4)：297.
6	Vaughn VM，Shuster D，Rogers MAM，et al.Early Versus Delayed Feeding in Patients With Acute Pancreatitis：A Systematic Review[J]．Ann Intern Med，2017，166(12)：883-892.
7	赵培培，王富兵，范辉，等．超早期肠内营养联合益生菌对重症急性胰腺炎患者的疗效[J]．中华胰腺病杂志，2019，19(2)：114-117.
8	Li XY，He C，Zhu Y，et al.Role of gut microbiota on intestinal barrier function in acute pancreatitis[J]．World J Gastroenterol，2020，26(18)：2187-2193.
9	袁伟，李娟，杨小娟，等．肠内营养对活动期溃疡性结肠炎伴营养不良患者营养状况、肠黏膜屏障功能和肠道菌群的影响[J]．现代生物医学进展，2022，22(14)：2658-2662.
10	Mederos MA，Reber HA，Girgis MD.Acute Pancreatitis：A Review[J]．JAMA，2021，325(4)：382-390.
11	佘会，崔霞，许勤勤，等．危重症患者早期肠内营养对营养指标、免疫功能、肠道损伤及并发症的影响[J]．海军医学杂志，2022，43(7)：727-731.
12	Yang AL，McNabb-Baltar J．Hypertriglyceridemia and acute pancreatitis[J]．Pancreatology，2020，20(5)：795-800.
13	官艳，王旋，洪琳，等．重症急性胰腺炎患者早期肠内营养误吸风险预测模型的构建[J]．护理学杂志，2022，37(8)：94-96.
14	Ramanathan M，Aadam AA.Nutrition Management in Acute Pancreatitis[J]．Nutr Clin Pract，2019，34：S7-S12.
15	王龙辉，刘群亮，周云鹏，等．肠型脂肪酸结合蛋白应用于重症急性胰腺炎胃肠道功能及病情评估的研究[J/OL]．中华普通外科学文献(电子版)，2020，14(3)：211-213.
16	Song J，Zhong Y，Lu X，et al.Enteral nutrition provided within 48 hours after admission in severe acute pancreatitis：A systematic review and meta-analysis[J]．Medicine(Baltimore)，2018，97(34)：e11871.
17	Gliem N，Ammer-Herrmenau C，Ellenrieder V，et al.Management of Severe Acute Pancreatitis：An Update[J]．Digestion，2021，102(4)：503-507.
18	陈妤，吴春松，江军兵．肠内营养联合微生态制剂对重症胰腺炎患者的疗效[J]．中国微生态学杂志，2021，33(1)：66-70.

组别	例数	ALB(g/L)		PA(mg/L)		TF(g/L)		AMC(cm)		TSF(mm)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	46	30.33±9.71	31.13±10.02	230.34±41.22	230.22±38.22	2.41±1.12	2.13±0.92	17.93±1.11	18.12±1.02	7.91±0.39	7.99±0.91
试验组	46	31.43±8.98	38.13±11.92	231.22±43.22	334.16±40.19	2.43±1.11	3.92±1.92	18.01±1.07	20.31±1.12	7.89±0.38	8.82±0.42
t		－0.564	－3.049	0.100	－12.711	－0.086	－5.702	－0.352	－9.805	0.249	－5.617
P		0.575	0.004	0.921	<0.001	0.932	<0.001	0.727	<0.001	0.804	<0.001

组别	例数	ALB(g/L)		PA(mg/L)		TF(g/L)		AMC(cm)		TSF(mm)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	46	30.33±9.71	31.13±10.02	230.34±41.22	230.22±38.22	2.41±1.12	2.13±0.92	17.93±1.11	18.12±1.02	7.91±0.39	7.99±0.91
试验组	46	31.43±8.98	38.13±11.92	231.22±43.22	334.16±40.19	2.43±1.11	3.92±1.92	18.01±1.07	20.31±1.12	7.89±0.38	8.82±0.42
t		－0.564	－3.049	0.100	－12.711	－0.086	－5.702	－0.352	－9.805	0.249	－5.617
P		0.575	0.004	0.921	<0.001	0.932	<0.001	0.727	<0.001	0.804	<0.001

组别	例数	乳杆菌	肠杆菌	肠球菌	双歧杆菌
试验组	46	6.17±1.58	5.01±1.22	10.89±2.91	5.81±2.15
对照组	46	3.34±1.34	7.19±2.01	7.91±1.88	2.31±1.29
t		9.265	6.288	－5.834	9.468
P		<0.001	<0.001	<0.001	<0.001

组别	例数	乳杆菌	肠杆菌	肠球菌	双歧杆菌
试验组	46	6.17±1.58	5.01±1.22	10.89±2.91	5.81±2.15
对照组	46	3.34±1.34	7.19±2.01	7.91±1.88	2.31±1.29
t		9.265	6.288	－5.834	9.468
P		<0.001	<0.001	<0.001	<0.001

组别	例数	D-乳酸(mg/L)	血清二胺氧化酶(ng/L)	血浆内毒素(EU/mL)
试验组	46	6.33±2.24	1.13±0.71	1.88±0.71
对照组	46	10.98±3.98	2.72±1.31	4.01±1.71
t		－6.906	－7.237	－7.802
P		<0.001	<0.001	<0.001

Please choose a citation manager

Content to export