双歧杆菌预防重症胰腺炎患者肠道菌群失调的临床研究

目的探讨双歧杆菌及早期肠内营养对急性重症胰腺炎（SAP）患者出现肠道菌群失调的预防及治疗作用。方法对2010年在成都市第五人民医院消化内科住院的99例SAP患者,随机分为3组：全胃肠外营养治疗组（TPN）;普通肠内营养（GEN）;生态营养组（EEN）（肠内营养加双歧杆菌管饲）,每组33例。分别观察3组患者腹痛缓解时间、血淀粉酶下降时间、肠道菌群失调症的发生率、平均住院日的差异。结果 SAP发病7～10 d时GEN及EEN组较TPN组相比,腹痛缓解时间、血淀粉酶恢复时间及并发症发生率均有显著降低（χ2=11.943,P〈0.01）。平均住院日（t=5.496,P〈0.01）明显缩短。SAP患者肠道菌群失调症总发生率是36.7%,TPN组肠道菌群失调发生率57.1%,GEN组肠道菌群发生率42.8%,EEN组肠道菌群发生率14.3%。结论生态营养组EEN较普通肠内营养组GEN和肠外营养组TPN能减少SAP肠道菌群失调的发生,并能缩短其病程,改善预后。

Bifidobacterium to prevent intestinal flora imbalance in patients with severe acute pancreatitis

Objective To explore the effects of Bifidobacterium and early enteral nutrition in proventing and treating intestinal flora imbalance(IFI) caused by Severe Acute Pancreatitis(SAP).Method 99 SAP inpatients in our hospital in 2010 were randomly divided into three groups: Total Parenteral Nutrition treatment group(TPN),General Enteral Nutrition(GEN),and Ecological Enteral Nutrition(EEN)(enteral nutrition and colon bacillus feeding tubes),33 cases each group.All three groups of patients were observed for their abdominal pain relief time,blood amylase decrease time,intestinal disorder incidence,and hospitalization period.Result Comparing to the TPN group,the abdomin pain relief time,blood amylase recovery time and complications in both GEN and EEN groups at day 7 to 10 after the onset of SAP were significantly reduced(χ2=11.943,P<0.01),and the hospitalization periods decreased ovbiously(t=5.496,P<0.01).The total incidence of intestinal flora imbalance in SAP patients was 36.7%,which was 57.1% in TPN group,42.8% in GEN group,and 14.3% in EEN group.Conclusion The EEN group obtained reduced incidence of IFI,shortened disease course and improved prognosis than GEN and TPN Groups did.