|
|
|
| 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.
|
|
|
|
|
|
[1] Lodewijkx PJ, Besselink MG, Witteman BJ, et al. Nutrition in acute pancreatitis: a critical review[J]. Expert Rev Gastroenterol Hepatol, 2016, 10(5):571~580.
[2] Shen QX, Xu GX, Shen MH. Effect of early enteral nutrition (EN) on endotoxin in serum and intestinal permeability in patients with severe acute pancreatitis.[J]. Eur Rev Med Pharmacol Sci, 2017, 21(11):2764~2768.
[3] 乔世刚,方理超,安堃,等.早期肠内滋养对重症创伤患者肠黏膜屏障的改善作用研究[J].中华急诊医学杂志,2017,26(9):1050~1053.
[4] Wen W, Zheng H, Jiang Y, et al. Effect of intestinal epithelial autophagy on bacterial translocation in severe acute pancreatitis[J]. Clin Res Hepatol Gastroenterol, 2017, 41(6):703~710.
[5] Nebot-Vivinus M, Harkat C , Bzioueche H , et al. Multispecies probiotic protects gut barrier function in experimental models[J]. World J Gastroenterol, 2014, 20(22):6832~6843.
[6] Liu D, Jiang XY, Zhou LS, et al. Effects of probiotics on intestinal mucosa barrier in patients with colorectal cancer after operation: meta-analysis of randomized controlled trials[J]. Medicine (Baltimore), 2016, 95(15):1~14
[7] Lemme-Dumit JM, Polti MA, Perdigón G, et al. Probiotic bacteria cell walls stimulate the activity of the intestinal epithelial cells and macrophage functionality[J]. Benef Microbes, 2018, 9(1):153~164.
[8] 张冰,王艳玲,李炳庆,等.四联疗法联合益生菌治疗幽门螺杆菌疗效观察[J].河北医学,2017,23(4):613~616.
[9] Van Baal MC, van Rens MJ, Geven CB, et al. Association between probiotics and enteral nutrition in an experimental acute pancreatitis model in rats[J]. Pancreatology, 2014, 14(6):470~477. |
|
|
|
2019, Vol. 25 
