Effect of Early Probiotics combined with Enteral Mutrition Intervention on Intestinal Tolerance and Inflammatory Mediators in Elderly Patients with SAP in ICU
WANG Xiao, ZHOU Wenlai
Dazhou Central Hospital, Sichuan Dazhou 635000, China
Abstract：Objective: To explore the clinical effects of early probiotics combined with enteral nutrition (EN) in elderly patients with severe acute pancreatitis (SAP). Methods: The clinical data of 116 elderly SAP patients were retrospectively analyzed. All patients were treated with conventional comprehensive therapy. Patients only with early EN intervention were included in control group (n=54), and patients with early probiotics combined with EN intervention were included in combined group (n=62). Before intervention and after 7d of intervention, the serum inflammatory mediators [interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α)], intestine mucosal functional indicators [diamine oxidase (DAO), dextrolactic acid (D-Lac), endotoxin] and humoral immune functional indicators [immunoglobulin A (IgA), IgG, IgM] were compared between the two groups, and the hospitalization record indexes, survival time and occurrence of intestinal intolerance symptoms within 7d were analyzed in the two groups. Results: After 7d of intervention, the levels of serum IL-6, IL-10, TNF-α, DAO, D-Lac and endotoxin in the two groups were significantly lower than those before intervention, and the levels in combined group were significantly lower than those in control group at the same time period (all P<0.05). The levels of serum IgA, IgG and IgM in the two groups were significantly higher than those before intervention, and the levels in combined group were significantly higher than those in control group at the same time period (all P<0.05). Within 7d after intervention, the incidence rates of abdominal distension and diarrhea in combined group were significantly lower than those in control group (all P<0.05), but there were no significant differences in the incidence rates of nausea/vomiting and constipation between the two groups (all P>0.05). There was no significant difference in survival time between the two groups (P>0.05). Among surviving patients, the abdominal pain relief time, oral feeding time, ICU stay and hospital stay in combined group were significantly lower than those in control group (all P<0.05). Conclusion: Early probiotics can effectively improve the EN tolerance of elderly SAP patients, help to improve the nutritional intervention effects, and promote the outcomes of disease, and it has high clinical application value.
王晓, 周文来. 早期益生菌结合肠内营养干预对ICU老年SAP患者肠道耐受性和炎症介质水平的影响[J]. 河北医学, 2019, 25(11): 1793-1798.
WANG Xiao, ZHOU Wenlai. Effect of Early Probiotics combined with Enteral Mutrition Intervention on Intestinal Tolerance and Inflammatory Mediators in Elderly Patients with SAP in ICU. HeBei Med, 2019, 25(11): 1793-1798.
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2019, Vol. 25 
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