Therapeutic Effect Of Probiotics Combined With Early Enteral Nutrition On Severe Acute Pancreatitis

Acute pancreatitis refers to the activation of pancreatic enzymes caused by various causes,followed by local inflammation of the pancreas as the main feature.Systemic inflammatory response syndrome(SIRS)can occur in patients with severe conditions and accompanied by organ dysfunction.Its etiology is various,mechanism is complex,course of disease progresses quickly,complications are numerous,treatment cycle is long,and mortality rate is high,which has become a major difficulty in clinical work.In the early stage of severe acute pancreatitis,the release of a large number of inflammatory factors triggers cascade amplification of inflammatory response and redistribution of body fluids,which often leads to a series of organ microcirculation disorders and even dysfunction.As one of the important target organs,the intestinal tract is accompanied by intestinal barrier dysfunction,impaired intestinal immune function,intestinal flora imbalance,bacterial translocation,resulting in infection and even aggravating other organ failure and other mid-term complications,which is an unavoidable problem in the treatment of severe pancreatitis.In recent years,more and more studies on probiotics in the treatment of severe acute pancreatitis have been carried out.It has been found that probiotics can improve the pathophysiological status of SAP through various ways and mechanisms.Probiotics have become a hot issue in the treatment of severe acute pancreatitis because they can improve intestinal barrier function,regulate intestinal mucosal immune function and prevent bacterial imbalance and bacterial translocation.However,because the results of different studies are too different,the therapeutic effect of probiotics on severe acute pancreatitis is still controversial.This study aimed to explore the effect of probiotics in the treatment of severe acute pancreatitis.It is expected that the addition of probiotics in early enteral nutrition can improve the prognosis of patients with pancreatitis and become a new method for the treatment of pancreatitis.Objective:This study was to investigate the effect of probiotics combined with early enteral nutrition on patients with severe acute pancreatitis,and to understand the efficacy and feasibility of probiotics in patients with severe acute pancreatitis.In order to alleviate the inflammatory reaction in patients with severe pancreatitis,relieve the clinical symptoms of patients,reduce the length of hospital stay,improve the prognosis,find new methods and reliable basis.Methods:A single-center,randomized,double-blind,placebo-controlled clinical trial was conducted to screen 51 patients admitted to hospital from February 2017 to December 2018 and diagnosed as severe acute pancreatitis.According to the early enteral nutrition supplemented with probiotics and placebo,they were divided into experimental group(group A,n=27)and control group(group B,n=24).Inflammation and laboratory biochemical indexes,incidence of infection,incidence of complications,abdominal pain relief time,need of surgical intervention and average length of hospital stay were compared between the two groups to explore the effect of probiotics on severe acute inflammation.Therapeutic effect.Results:Compared with group B,the inflammatory indexes(WBC and CRP values)recovered faster in group A(7 days after treatment and 14 days after treatment),P < 0.05,the difference was statistically significant;AMY level in group A decreased faster than that in group B(7 days and 14 days after treatment),P < 0.05,the difference was statistically significant;abdominal pain relief time in group A was shorter than that in group B,P < 0.05,the difference was statistically significant;The incidence of infection-related complications was significantly lower in group A than in group B(P < 0.05).There were 1 case of bloodstream infection in group A,2 cases of pulmonary infection in group A,3 cases of pulmonary infection in group B,and 2 cases of abdominal infection in group A and 3 cases of group B.There was no significant difference in surgical intervention between group A and group B,and there was no significant difference in other related complications(digestive tract hemorrhage,abdominal hemorrhage,intestinal leakage,etc.)between group A and group B.The average hospitalization days of group A were shorter than those of group B,P < 0.05,the difference was statistically significant;the mortality rate of group A was lower than that of group B,P < 0.05,the difference was statistically significant.Conclusion:In the treatment of severe acute pancreatitis,early enteral nutrition combined with probiotics can promote the recovery of inflammation indicators,alleviate abdominal pain symptoms,reduce the incidence of infection and average hospital stay,and accelerate the recovery of patients with severe acute pancreatitis,which is worthy of further study and promotion.