不同营养支持对急性重症胰腺炎的效果对比及对血清钙离子、hs-CRP、AMS、PCT的影响

摘要 目的：探讨不同营养支持对急性重症胰腺炎的效果对比及对血清钙离子、超敏C反应蛋白（hs-CRP）、淀粉酶（AMS）、降钙素原（PCT）的影响。方法：选择2015年1月到2020年12月在我院接受治疗的131例急性重症胰腺炎患者，采用随机数表法分为试验组（n=66）和对照组（n=65）。对照组给予肠外营养支持治疗，试验组给予肠内营养支持治疗。比较两组临床疗效、钙离子、hs-CRP、AMS、PCT、D-乳酸、二胺氧化酶（DAO）、内毒素、临床症状改善情况及不良反应发生情况。结果：治疗后，两组总有效率比较差异显著（P<0.05）；治疗前，试验组和对照组血清抑钙离子、hs-CRP、AMS、PCT比较无显著差异；治疗后，试验组和对照组血清hs-CRP、AMS、PCT随着时间的推移而降低，且试验组均低于对照组，血清钙离子随着时间的推移而升高，且试验组高于对照组，差异显著（P<0.05）；治疗前，试验组和对照组血清D-乳酸、DAO、内毒素比较无显著差异；治疗后试验组和对照组血清D-乳酸、DAO、内毒素随着时间的推移而降低，且试验组均低于对照组，差异显著（P<0.05）；试验组腹痛缓解、肠鸣音恢复、血淀粉酶恢复及尿淀粉酶恢复时间均显著低于对照组，差异显著（P<0.05）；两组不良反应总发生率分别为9.09%、15.38%（P>0.05）。结论：在急性重症胰腺炎患者中应用肠内营养支持效果显著，可有效改善血清钙离子、hs-CRP、AMS、PCT水平，且不良反应较低。

Comparison of the Effects of Different Nutritional Support on Acute Severe Pancreatitis and the Effects on Serum Calcium, hs-CRP, AMS and PCT

ABSTRACT Objective: To study Comparison of the effects of different nutritional support on acute severe pancreatitis and the effects on serum calcium, Hypersensitive C-reactive protein (hs-CRP), amylase (AMS), procalcitonin (PCT). Methods: 131 patients with severe acute pancreatitis treated in our hospital from January 2015 to December 2020 were selected and divided into experimental group (n=66) and control group(n=65) by random number table method. The control group was given parenteral nutrition support treatment, and the experimental group was given enteral nutrition support treatment. Clinical efficacy, calcium ions, hs-CRP, AMS, PCT, D-lactic acid, diamine oxidase(DAO), endotoxin, improvement of clinical symptoms and the incidence of ADR were compared between the two groups. Results: After treatment, the total effective rate between the two groups was significantly different(P<0.05). Before treatment, there were no significant differences in serum calcium inhibition, hs-CRP, AMS and PCT between the test group and the control group. After treatment, the serum hs-CRP, AMS and PCT of experimental group and control group decreased with the passage of time, and those of experimental group were lower than those of control group, while the serum calcium ion increased with the passage of time, and the difference was significant (P<0.05). Before treatment, there were no significant differences in serum D-lactic acid, DAO and endotoxin between experimental group and control group. After treatment, D-lactic acid, DAO and endotoxin in serum of experimental group and control group decreased with time, and the difference was significant(P<0.05). The recovery time of abdominal pain relief, intestinal sound recovery, blood amylase recovery and urine amylase recovery in experimental group were significantly lower than those in control group, the differences were significant (P<0.05); The total incidence of ADR in the two groups was 9.09% and 15.38% (P>0.05), respectively. Conclusion: The application of enteral nutrition support in patients with acute severe pancreatitis has a significant effect, which can effectively improve the levels of serum calcium ions, hs-CRP, AMS and PCT, with low adverse reactions.