重症急性胰腺炎穿刺引流术后早期肠内生态免疫营养的应用研究

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1、授予单位代码10089-学号或申请号13497'HebeiMedicalUniversity硕士学位论文在职科学学位重症急性胰腺炎穿刺弓I流术后早期肠内生态免疫营养的应用研究学位申请人：陈新导师：刘建华教授专业：外科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下，由本人独立完成。本学位论文研究所获得的研究成果》其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科大学，试验材料、原始数据、申报的专利等知识产权均归

2、河北医科大学所有<»否则,承担相应法律责任。，研究生签名：於对导师签章:级学院领导毒章：河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外,文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名：导师签章:一沙年疒M日目录中文摘要·············································································1英文摘要··························

3、···················································3研究论文重症急性胰腺炎穿刺引流术后早期肠内生态免疫营养的应用研究前言·············································································5材料与方法····································································6结果··············································

4、·······························7附图·············································································9附表·············································································11讨论·············································································13结论··········

5、···································································16参考文献·······································································17综述急性胰腺炎的肠内营养治疗···············································20致谢···········································································

6、········27个人简历·············································································28中文摘要重症急性胰腺炎穿刺引流术后早期肠内生态免疫营养的应用研究摘要目的：探讨重症急性胰腺炎（SAP）经介入引流后，早期肠内生态免疫营养对患者营养状态、免疫功能、炎症反应和预后方面的临床疗效。方法：选择2012年01月-2014年12月我院收治的35例SAP患者作为研究对象，均符合SAP诊断标准。将35例患者随机分为2组：静脉营养组(PN组，15例)和肠内生态免疫营养组(EEIN组，

7、20例)。PN组接受3L袋的全胃肠外营养；EEIN组的胰腺坏死组织经超声介入穿刺引流内24h，通过内镜引导放置鼻肠营养管行生态免疫营养。2组患者均于治疗前及治疗后7d和14d分别取血测定前白蛋白(PAB)、转铁蛋白(TF)；C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）；CD4+、CD8+、CD4+/CD8+的T淋巴细胞亚群；IgA、IgG、IgM免疫球蛋白各项指标。并观察2组患者的腹部症状，统计2组患者感染率、大便菌群失调和中转手术率。结果：1治疗后2组患者的前白蛋白、转铁蛋白均有不同程度升高，EEIN组高于PN组，差异有统计学意