实用医学杂志 ›› 2021, Vol. 37 ›› Issue (18): 2395-2400.doi: 10.3969/j.issn.1006⁃5725.2021.18.018

• 临床研究 • 上一篇    下一篇

不同进食时间对急性胰腺炎患者术后疗效及胃肠功能恢复、体液免疫指标的影响

李红英, 孟明明   

  1. 首都医科大学附属北京世纪坛医院消化内科(北京100038)

  • 出版日期:2021-09-25 发布日期:2021-09-25
  • 通讯作者: 孟明明 E⁃mail:yueliante@126.com
  • 基金资助:

    北京市医管局培育课题(编号:PX2019025)


Effect of feeding at different times on postoperative curative effect,gastrointestinal function recovery and humoral immune indexes in patients with acute pancreatitis

LI Hongying,MENG Mingming.    

  1. Department of Gastroenterology,Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China

  • Online:2021-09-25 Published:2021-09-25
  • Contact: MENG Mingming E⁃mail:yueliante@126.com

摘要:

目的 探讨不同进食时间对急性胰腺炎患者术后疗效及胃肠功能恢复、体液免疫指标的影响。方法 回顾性分析我院于 2010 1 月至 2020 1 月收治的经手术治疗的 100 AP 患者临床资料,根据患者术后进食时间,分为三组:A 24 h 内进食,B 24 ~ 48 h 内开始进食,C 48 ~ 72 h 开始进食,对比三组患者手术指标、疗效、营养状况、胃肠功能恢复情况、免疫功能及并发症发生率。结果 治疗总有效率比较 A 组(91.2%)>B 组(85.1%)>C 组(82.1%),但差异无统计学意义(P > 0.05);三组患者手术时间、 术中出血量及术后切口恢复情况差异无统计学意义(P > 0.05);自觉肠蠕动时间、首次排气时间、排便时间比较 A 组<B 组<C 组,食欲比较 A 组>B 组>C 组,差异具有统计学意义(P < 0.05);三组术后白蛋白和 前白蛋白水平显著升高(P < 0.05),组间比较 A 组高于 B 组和 C 组(P < 0.05);三组术后各项免疫指标均先 下降后升高(P < 0.05),组间比较 A 组高于 B 组和 C 组(P < 0.05);拆线时间、总住院时间和住院总费用比 A 组<B 组<C 组;A 组并发症发生率(2.9%)显著低于 B 组(3.7%)和 C 组(20.5%),差异具有统计学意义 P < 0.01)。结论 术后不同进食时间显著影响 AP 患者术后胃肠功能恢复,术后 24 h 内进食安全、有效, 能够促进胃肠功能恢复,改善营养状况和免疫功能,从而减少并发症的发生,缩短住院时间,减轻治疗成本,值得临床推广。

关键词:

急性胰腺炎, 术后疗效, 胃肠恢复, 体液免疫

Abstract:

Objective To explore the effect of feeding at different times on postoperative curative effect gastrointestinal function recovery and humoral immune indexes in patients with acute pancreatitis(AP). Methods A retrospective analysis on the clinical data of 100 AP patients who were treated in our hospital from January 2010 to January 2020 was done. The patients were divided into three groups according to the postoperative feeding times group A feeding within 24 hours,group B within 24 to 48 h,group C within 48 ~ 72 h. The three groups were compared in terms of the surgical indicators,curative effect,nutritional status,gastrointestinal function recovery immune function and complication rate. Results The total effective rate of group A was insignificantly higher than group B(91.2% vs. 85.1%,P > 0.05)and higher than group C(91.2% vs. 82.1%,P > 0.05). There was no significant difference in operation time,intraoperative blood loss and postoperative incision recovery among the three groups of patients(P > 0.05). The time of conscious bowel movement,the time of first exhaust,and the time of defecation of group A was significantly than group B and group C(P < 0.05),and appetite in group A was significantly better than group B and group C(P < 0.05). The levels of albumin and prealbumin in the three groups all increased significantly after surgery(P < 0.05),and among the groups,the level in group A was higher than in both group B and group C(P < 0.05). The immune indexes of all the three groups decreased first and then increased(P < 0.05), and immune indexes in group A were significantly higher than those in group B and group C(P < 0.05). Suture removal time,total length of hospital stay,and total hospitalization costs in group A were significantly lower than group B and group C,and the complication rate of group A was significantly lower than group B(2.9% vs. 3.7% P < 0.01)and group C(2.9% vs. 20.5%,P < 0.01). Conclusion Different feeding times after surgery significantly affect the recovery of gastrointestinal function of AP patients Eating within 24 hours after surgery is safe and effective,which can promote the recovery of gastrointestinal function and improve nutritional status and immune function,thereby reducing the occurrence of complications,shortening the length of hospitalization,and reducing the cost of treatment,it is worthy of clinical promotion.

Key words:

acute pancreatitis, postoperative efficacy, gastrointestinal recovery, humoral immunity