The effects of enteral nutrition versus total parenteral nutrition on gut barrier function in severe acute pancreatitis
10.3760/cma.j.issn.0578-1426.2011.05.004
- VernacularTitle:肠内营养与肠外营养对重症急性胰腺炎患者肠屏障功能影响的比较
- Author:
Chunfang XU
;
Xiaoxi HUANG
;
Yunzhi SHEN
;
Xingpeng WANG
;
Lei GONG
;
Yadong WANG
- Publication Type:Journal Article
- Keywords:
Enteral nutrition;
Parenteral nutrition,total;
Severe acute pancreatitis;
Gut barrier function
- From:
Chinese Journal of Internal Medicine
2011;50(5):370-373
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of enteral nutrition (EN) versus total parenteral nutrition(TPN) on gut barrier function in patients with severe acute pancreatitis (SAP). Methods Sixtythree patients with SAP enrolled from 4 hospitals were randomly assigned into EN group(29 cases) and TPN group(34 cases). EN group patients were fed via a spiral nasojejunal feeding tube placed routinely by endoscopy or fluoroscopy, and TPN group patients were nourished intravenously with TPN during the same period. The changes of serum endotoxin, diamine oxidase, and urinary excretion of lactulose and mannitol ratio (L/M) were observed. Results Plasma concentration of endotoxin were markedly decreased in EN group as compared with that in TPN group at the 7th,14th ,21th day of entry trial [(39. 30 ± 15. 82) EU/L vs (73.05 ±21.16) EU/L,(22.64 ±14.31) EU/L vs (49.34 ±24.54) EU/L,(14.81 ± 10.93)EU/L vs ( 30. 08 ± 14. 10 ) EU/L, P < 0. 05]. Plasma concentration of diamine oxidase were markedly decreased in EN group as compared with that in TPN group at the 7th, 14th day of entry trial [(9. 97 ± 3. 84)U/Lvs (19.89±9.89)U/L,(5.42±1. 84) U/Lvs (8.79 ±4.08) U/L, both P < 0. 05]. The urinary L/M decreased significantly in EN group than those in TPN group at the 7th, 14th,21th day of entry trial (0.28 ±0.25 vs 0. 65 ±0.45,0.21 ±0. 18 vs 0.54 ±0.41,0.08 ±0.04 vs 0.29 ±0.06, all P<0.05).Conclusion EN has better effect on improving intestinal barrier function than TPN in treatment of patients with SAP.