異甘草酸鎂與谷氨酰胺聯(lián)合腸內(nèi)營養(yǎng)支持治療重癥急性胰腺炎的效果

夏秀梅　周偉

【摘要】 目的：探究異甘草酸鎂與谷氨酰胺聯(lián)合腸內(nèi)營養(yǎng)支持治療重癥急性胰腺炎的效果。方法：選取筆者所在醫(yī)院2018年5月-2019年8月SAP患者82例，根據(jù)治療方案不同分為兩組，各41例。對照組給予腸內(nèi)營養(yǎng)支持，觀察組于對照組基礎(chǔ)上加用異甘草酸鎂、谷氨酰胺。對比兩組療效、治療7、14 d的APACHEⅡ評分及治療前后腸黏膜屏障功能指標(biāo)[二胺氧化酶（DAO）、D-乳酸]水平。結(jié)果：觀察組總有效率高于對照組（P<0.05）;治療7、14 d，觀察組APACHEⅡ評分低于對照組（P<0.05）;治療后觀察組血清DAO、D-乳酸水平低于對照組（P<0.05）。結(jié)論：異甘草酸鎂與谷氨酰胺聯(lián)合腸內(nèi)營養(yǎng)支持治療SAP患者，可降低APACHEⅡ評分，改善腸黏膜屏障功能，療效顯著。

【關(guān)鍵詞】 異甘草酸鎂 谷氨酰胺 腸內(nèi)營養(yǎng)支持 重癥急性胰腺炎

doi：10.14033/j.cnki.cfmr.2020.16.018 文獻標(biāo)識碼 B 文章編號 1674-6805（2020）16-00-03

Effect of Magnesium Isosglycyrrhizinate and Glutamine Combined with Enteral Nutrition Support in the Treatment of Severe Acute Pancreatitis/XIA Xiumei， ZHOU Wei. //Chinese and Foreign Medical Research， 2020， 18（16）： -48

[Abstract] Objective： To investigate the effect of Magnesium Isosglycyrrhizinate and Glutamine combined with enteral nutritional support in the treatment of severe acute pancreatitis. Method： A total of 82 cases of SAP patients in our hospital from May 2018 to August 2019 were selected， according to different treatment schemes， they were divided into two groups. 41 cases in each group. The control group was given enteral nutrition support， and the observation group was added with Magnesium Isosglycyrrhizinate and Glutamine on the basis of the control group. Compared the two groups of curative effect， APACHE Ⅱ score of treatment for 7， 14 days and intestinal mucosal barrier function indexes before and after the treatment [diamine oxidase （DAO）， D-lactate] levels. Result： The total effective rate of the observation group was higher than that of the control group （P<0.05）. Treatment for 7， 14 days， the APACHE Ⅱ score of study group were lower than those of the control group （P<0.05）. After treatment， serum DAO and D-lactic acid levels in the observation group were lower than those in the control group （P<0.05）. Conclusion： Magnesium Isosglycyrrhizinate， Glutamine combined with enteral nutrition support can reduce APACHE Ⅱ score and improve intestinal mucosal barrier function in SAP patients， with significant therapeutic effect.

[Key words] Magnesium Isosglycyrrhizinate Glutamine Enteral nutrition support Severe acute pancreatitis

First-authors address： Xiaogan Central Hospital， Xiaogan 432000， China

重癥急性胰腺炎（severe acute pancreatits，SAP）為嚴(yán)重急腹癥，可引發(fā)急性呼吸窘迫綜合征、多器官衰竭、休克等并發(fā)癥，病死率可達20%～30%[1-2]。腸內(nèi)營養(yǎng)為SAP重要營養(yǎng)補給方式，可維護腸屏障，促進腸功能恢復(fù)及蛋白合成[3]。近年來，谷氨酰胺作為腸黏膜細(xì)胞危重應(yīng)激狀態(tài)下的唯一能量來源，在SAP治療中的應(yīng)用備受臨床關(guān)注[4]。異甘草酸鎂具有較好的抗炎及免疫調(diào)節(jié)作用[5]。本研究選取筆者所在醫(yī)院SAP患者82例，探究異甘草酸鎂與谷氨酰胺聯(lián)合腸內(nèi)營養(yǎng)支持對其急性生理功能和慢性健康狀況評分系統(tǒng)Ⅱ（APACHEⅡ）評分及腸黏膜屏障功能的影響，現(xiàn)報道如下。