Clinic Study Of Early Enteral Ecoimmunonutrition Combined With Percutaneous Drainage For Patients With Severe Acute Pancreatitis

Objective: To study the clinical effect of early enteral ecoimmunonutrition on nutritional status, immune function,inflammatory response and prognosis for the patients with severe acute pancreatitis(SAP) after percutaneous drainage.Methods: A retrospective review was performed in clinical data of 35 patients corresponding to Chinese diagnosis standards of SAP in our hospital during January 2012 and November 2014,35 patients were randomly divided into two groups:parenteral nutrition group(PN group,15cases),enteral ecoimmunonutri-tion group(EEIN group,20 cases).PN group received total parenteral nutrition through 3L infusion bag.After EEIN group complicated with pancreatic necrosis received percutaneous drainage guided by ultrasound, meanwhile the nasointestinal tube was placed in proximal jejunum guided by endoscopy,then they were fed by enteral ecoimmunonutrition with 24 hours.Before nutrition treatment and then 7 and 14 days after treatment,blood samples were collected for analysis of pre-albumin(PAB),transferrin(TF), C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α), immunoglobulin A(Ig A),immunoglobulin G(Ig G), immunoglobulin M(Ig M), CD4+,CD8+ and CD4+/CD8+ lymphocyte subsets.Then clinical changes of abdominal symptoms were observed,meanwhile, the infection rate,rate of stool dysbacteriosis,the operation rate were measured.Results:1 After nutrition treatment,for the level of PAB and TF, EEIN group were higher than PN group(all P<0.05).2 After nutrition treatment,for the level of CD4,CD8, CD4/CD8 and Ig A, EEIN group were higher than PN group(all P<0.05). For the level of Ig G and Ig M, but there was no difference between two groups(all P>0.05).3 After nutrition treatment,for the level of CRP,IL-6 and TNF-α,EEIN group were lower than PN group(all P<0.05).4 For the clinical changes of abdominal symptoms,infection rate,rate of stool dysbacteriosis and operation rate,EEIN group were superior to PN group(all P<0.05).Conclusion: For the patients with severe acute pancreatitis complicated with pancreatic necrosis,percutaneous drainage can relieve abdominal symptoms. Early enteral ecoimmunonutrition can improve body nutritional condition and immunological function,promote recovery of digestive function,prevent the bacterial translocation,reduce inflammatory response,and superior to total parenteral nutrition alone.