谷氨酰胺在老年急性胰腺炎肠屏障功能障碍患者中的治疗作用

摘要

目的：探讨谷氨酰胺在老年急性胰腺炎肠屏障功能障碍患者中的治疗作用。方法将100例患者随机分为两组,对照组应用补液、胃肠持续减压、抑制胰腺分泌等常规处理措施,研究组则在常规处理措施的基础上给予静脉输注谷氨酰胺处理；比较两组腹痛腹胀消失时间、治疗前后血液内毒素浓度、尿乳果糖/甘露醇比值情况等。结果研究组腹痛腹胀消失时间、机械通气时间、ICU 入住时间分别为(6.5±1.1)、(7.4±2.1)、(10.6±3.9)d,均较对照组明显缩短(P <0.05)；研究组治疗后血液内毒素浓度、尿乳果糖/甘露醇比值依次为(0.17±0.03)EU/L、(0.15±0.05),均较对照组患者明显降低(P <0.05)。结论谷氨酰胺治疗老年急性胰腺炎肠屏障功能障碍临床效果较佳,可加快肠道运动功能的恢复,有效减轻内毒素血症。%Objective To observe the treatment effect of glutamine in elderly patients with acute pancreatitis intestinal barrier dysfunction.Methods 100 patients were randomly divided into 2 groups.The control group applied the conventional treatment measures of fluid infusion,gastrointestinal continuous decompression and inhibition of pancreatic secretion,while on this basis the study group was given intravenous infusion of glutamine;the abdominal pain and distension disappearance time,blood endotoxin concentration,urine lactulose/mannitol ratio before and after treatment were compared between the two groups.Results The abdominal pain and distension disappearance time, duration of mechanical ventilation and ICU stay time in the study group were (6.5 ± 1.1 )d,(7.4 ± 2.1 )d and (10.6±3.9)d respectively,which were significantly shorter than those in the control group (P <0.05 );the blood endotoxin concentration and urine lactulose/mannitol ratio after treatment in the study group were (0.1 7 ± 0.03 ) EU/L and (0.1 5 ± 0.05 )respectively,which were significantly decreased compared with the control group (P <0.05).Conclusion Glutamine for treating intestinal barrier dysfunction in elderly patients with acute pancreatitis has better clinical effect,can accelerate the recovery of intestinal motor function and effectively alleviates endotoxemia.