早期肠内营养对危重症患者胰腺 外分泌功能不全的影响

Effect of early enteral nutrition on pancreatic exocrine insufficiency in critically ill patients

摘要:

目的 探讨早期肠内营养对危重症患者胰腺外分泌功能不全（PEI）的影响。方法 通过检测危 重症患者粪弹力蛋白酶1（FE-1）浓度，筛选PEI 患者，采用随机数字表法将PEI 患者分为早期肠内营养支 持组（A 组，<24 h）和肠内营养组（B 组，≥ 24 h）。分别检测入ICU 第3 和5 天两组粪FE-1 浓度；计算两 组不同时间段继发PEI 比例，并记录两组ICU 住院时间及总住院时间。结果 A 组不同时间点粪FE-1 浓度 较B 组更高（P <0.05），且并发PEI 比列更低（P <0.05）；且A 组ICU 住院时间更短（P <0.05）。结论 早 期肠内营养支持能改善危重症患者的PEI，并可能因此而缩短危重症患者ICU 住院时间。

Abstract:

Objective To investigate the effect of early enteral nutrition on pancreatic exocrine insufficiency in critically ill patients. Methods To divided the critically ill patients with pancreatic exocrine insufficiency into group A and group B. The group A accepted enteral nutrition within 24 hours following admission to ICU, while the group B accepted that after 24 hours following admission to ICU. After that, the fecal elastin-1 (FE-1) concentration were detected and compared on the third day and the fifth day. The proportion of secondary PEI in two groups at different time periods was calculated, and the length of ICU stay and total length of stay were recorded. Results Group A showed higher fecal elastin-1 concentration both in the third day and the fifth day (P < 0.05) and lower incidence of pancreatic exocrine insufficiency (P < 0.05) than group B. Meanwhile, group A showed shorter ICU stay than group B (P < 0.05). Conclusions Early enteral nutrition appears a positive effect on critically ill patients with pancreatic exocrine insufficiency and reduces their ICU stay.