[1]王跃生,赵铁锁.可溶性膳食纤维对儿童急性胰腺炎胃肠功能的影响[J].医学信息,2022,35(23):104-107.[doi:10.3969/j.issn.1006-1959.2022.23.019]
　WANG Yue-sheng,ZHAO Tie-suo.Effect of Soluble Dietary Fiber on Gastrointestinal Function in Children with Acute Pancreatitis[J].Journal of Medical Information,2022,35(23):104-107.[doi:10.3969/j.issn.1006-1959.2022.23.019]
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可溶性膳食纤维对儿童急性胰腺炎胃肠功能的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年23期
页码:
104-107
栏目:
临床研究
出版日期:
2022-12-01

文章信息/Info

Title:
Effect of Soluble Dietary Fiber on Gastrointestinal Function in Children with Acute Pancreatitis
文章编号:
1006-1959（2022）23-0104-04
作者:
王跃生; 赵铁锁
（新乡医学院，河南 新乡 453003）
Author(s):
WANG Yue-sheng; ZHAO Tie-suo
(Xinxiang Medical University,Xinxiang 453003,Henan,China)
关键词:
可溶性膳食纤维; 肠内营养; 急性胰腺炎; 胃肠功能耐受
Keywords:
Soluble dietary fiber; Enteral nutrition; Acute pancreatitis; Gastrointestinal function tolerance
分类号:
R459.3
DOI:
10.3969/j.issn.1006-1959.2022.23.019
文献标志码:
A
摘要:
目的 探讨可溶性膳食纤维（SDF）对儿童急性胰腺炎胃肠功能耐受、黏膜屏障及临床疗效的影响。方法 回顾性分析新乡医学院附属郑州儿童医院2018年1月-2020年12月收治的38例急性胰腺炎患儿，根据治疗方式分为对照组（17例）和治疗组（21例），对照组接受单纯早期肠内营养（EEN）治疗，治疗组接受添加SDF的EEN治疗。两组均于24 h内胃镜引导下置入鼻肠管至Treitz韧带远端，连续泵入糖盐水、小百肽等热卡营养物质，治疗组于开始EEN时添加SDF溶于肠内营养液；比较两组临床特征、胃肠功能耐受、肠道黏膜屏障及住院时间。结果 治疗组达到目标热量时间短于对照组，腹胀、腹泻和便秘喂养不耐受症状发生率少于对照组，差异有统计学意义（P＜0.05）；治疗组第14天肠鸣音次数多于对照组，第一次排气、排便时间短于对照组，差异有统计学意义（P＜0.05）；治疗组脂肪酶、血淀粉酶低于对照组，肠粘膜屏障功能相关指标优于对照组，差异有统计学意义（P＜0.05）；治疗组TNF-α、IL-6低于对照组，差异有统计学意义（P＜0.05）；治疗组第14天APACHEⅡ评分、BISAP评分均低于对照组，ICU住院天数、总住院天数短于对照组，差异有统计学意义（P＜0.05）。结论 EEN添加SDF可缩短EN期间达到能量目标时间，改善肠道功能，减少炎症反应，降低胰腺炎患儿摄食不耐受的发生率。
Abstract:
Objective To investigate the effect of soluble dietary fiber (SDF) on gastrointestinal function tolerance, mucosal barrier and clinical efficacy in children with acute pancreatitis.Methods A retrospective analysis was performed on 38 children with acute pancreatitis admitted to Zhengzhou Children’s Hospital Affiliated to Xinxiang Medical University from January 2018 to December 2020. According to the treatment methods, they were divided into control group (17 cases) and treatment group (21 cases). The control group received simple early enteral nutrition (EEN) treatment, and the treatment group received SDF-added EEN treatment. In both groups, the nasointestinal tube was inserted into the distal end of Treitz ligament under the guidance of gastroscope within 24 hours, and the calorie nutrients such as sugar saline and small peptide were continuously pumped. In the treatment group, SDF was added to the enteral nutrient solution at the beginning of EEN. The clinical characteristics, gastrointestinal function tolerance, intestinal mucosal barrier and hospitalization time were compared between the two groups.Results The time of reaching the target calorie in the treatment group was shorter than that in the control group, and the incidence of abdominal distension, diarrhea and constipation feeding intolerance in the treatment group was lower than that in the control group, the difference was statistically significant (P<0.05). The number of bowel sounds in the treatment group on the 14th day was more than that in the control group, and the first exhaust and defecation time was shorter than that in the control group, the difference was statistically significant (P<0.05). The lipase and blood amylase in the treatment group were lower than those in the control group, and the related indexes of intestinal mucosal barrier function were better than those in the control group, the difference was statistically significant (P<0.05). The levels of TNF-α and IL-6 in the treatment group were lower than those in the control group, the difference was statistically significant (P<0.05). The APACHEⅡ score and BISAP score of the treatment group on the 14th day were lower than those of the control group, and the ICU hospitalization days and total hospitalization days were shorter than those of the control group, the difference was statistically significant (P<0.05).Conclusion EEN supplemented with SDF can shorten the time to reach the energy target during EN, improve intestinal function, reduce inflammation, and reduce the incidence of feeding intolerance in children with pancreatitis.

参考文献/References:

[1]Restrepo R,Hagerott HE,Kulkarni S,et al.Acute Pancreatitis in Pediatric Patients: Demographics, Etiology, and Diagnostic Imaging[J].AJR Am J Roentgenol,2016,206(3):632-644.[2]Sarah C,Martin W,Steven W,et al.Classification and Nutrition Management of Acute Pancreatitis in the Pediatric Intensive Care Unit[J].J Pediatr Gastroenterol Nutr,2018,67(6):755-759. [3]Hideto Y,Masayasu H,Masamitsu S,et al.Etiology and mortality in severe acute pancreatitis: A multicenter study in Japan[J].Pancreatology,2020,20(3):307-317.[4]Singer P,Blaser AR,Berger MM,et al.ESPEN guideline on clinical nutrition in the intensive care unit[J].Clin Nutr,2019,38(1):48-79.[5]Uc A,Perito ER,Pohl JF,et al.International Study Group of Pediatric Pancreatitis: In Search for a CuRE Cohort Study:Design and Rationale for INSPPIRE 2 From the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer[J].Pancreas,2018,47(10):1222-1228.[6]郭晓钟.重症急性胰腺炎致全身炎症反应综合征的诊治策略[J].中华消化杂志,2019,39(5):289-291.[7]王菁,赵晶晶,姚莉.重症急性胰腺炎发生胃肠功能障碍的危险因素分析[J].中华胰腺病杂志,2020,20(5):380-382.[8]宋建花.保留灌肠结合胃肠减压在中度重症急性胰腺炎并发麻痹性肠梗阻中的应用[J].中国肛肠病杂志,2021,41(4):17-18.[9]Roberts KM,Nahikian-Nelms M,Ukleja A,et al.Nutritional Aspects of Acute Pancreatitis[J].Gastroenterol Clin North Am,2018,47(1):77-94.[10]Jin Z,Wang Z,Wang J.Early Enteral Nutrition Prevent Acute Pancreatitis From Deteriorating in Obese Patients[J].J Clin Gastroenterol,2020,54(2):184-191.[11]Magdy ES,Synne OY,Tarek M,et al.Dietary fiber in irritable bowel syndrome[J].Int J Mol Med,2017,40(3):607-613.[12]Generoso SV,Lages PC,Correia M.Fiber, prebiotics, and diarrhea: what, why, when and how[J].Curr Opin Clin Nutr Metab Care,2016,19(5):388-393.[13]Weimann A,Felbinger TW.Gastrointestinal dysmotility in the critically ill: a role for nutrition[J].Curr Opin Clin Nutr Metab Care,2016,19(5):353-359.[14]Barlass U,Dutta R,Cheema H,et al.Morphine worsens the severity and prevents pancreatic regeneration in mouse models of acute pancreatitis[J].Gut,2018,67(4):600-602.[15]王跃生,张敬,李小芹,等.ω-3多不饱和脂肪酸早期肠内营养对儿童重症急性胰腺炎肠屏障功能影响的临床研究[J].中国小儿急救医学,2014,21(8):520-522.[16]Gibson GR,Hutkins R,Sanders ME,et al.Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics[J].Nat Rev Gastroenterol Hepatol,2017,14(8):491-502.[17]王跃生,李小芹,张敬.ω-3多不饱和脂肪酸早期肠内营养对儿童急性胰腺炎细胞因子和免疫功能的影响[J].中国儿童保健杂志,2017,25(1):66-69.[18]中华医学会消化病学分会胰腺疾病学组.中国急性胰腺炎诊治指南(2019,沈阳)[J].中华胰腺病杂志,2019,19(5)321-331.[19]李曼,邢小康,郭丰.6种评分系统和4个实验室检查指标对重症急性胰腺炎预后的评估作用[J].中华消化杂志,2018,38(10):673-677.[20]Chen T,Ma Y,Xu L,et al.Soluble Dietary Fiber Reduces Feeding Intolerance in Severe Acute Pancreatitis: A Randomized Study[J].JPEN J Parenter Enteral Nutr,2021,45(1):125-135.[21]王如意,昝建宝,何承龙,等.序贯性早期肠内营养在中度重症急性胰腺炎患者治疗中的作用[J].医学信息,2019,32(23):89-92.

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更新日期/Last Update: 1900-01-01