Therapeutic effects of ultra early enteral nutrition with probiotics in treating severe acute pancreatitis patients

Abstract

Objective To investigate the curative effect of ultra early enteral nutrition (EN) supplemented with probiotics in patients with severe acute pancreatitis (SAP). Methods Seventy-five SAP cases admitted in Second People′s Hospital of Nantong from December 2014 to June 2018 were enrolled and assigned into 24 h group (who received EN & probiotics at 24 h, n=25), 72 h group (who received EN & probiotics at 72 h, n=25) and the control group (who received EN & probiotics on day 7, n=25). After admission, the levels of PCT, hs-CRP and endotoxin on day 1, 4 and 8 were detected.APACHEⅡ score on day 3 after admission, complication rate, infection rate, hospitalization duration and mortality were recorded. Results On day 1 after admission, serum PCT, hs-CRP and endotoxin concentrations among three groups were of no significant differences. On day 4 after admission, the serum concentrations of PCT and edotoxin in 24 h group were significantly lower than those in 72 h group and the control group [(3.12±1.45)μg/L vs (5.26±1.52), (6.07±1.59)μg/L; (0.24±0.02)EU/ml vs (0.35±0.03), (0.46±0.04) EU/ml]. The serum hs-CRP in 24 h group was significantly lower than that of the control group [(20.71±4.89)μg/L vs(28.37±4.64)μg/L], and the difference was statistically significant (P<0.05). The serum concentrations of hs-CRP in 24 h group and 72 h group was of no significant difference. On day 7 after admission, the serum concentrations of PCT, hs-CRP and endotoxin in 24 h group were significantly lower than those in 72 h group and the control group (P<0.05); the serum concentrations of PCT, hs-CRP and endotoxin in 72 h group were significantly lower than those of the control group, and all the differences were statistically significant (all P<0.05). The score of APACHEⅡ (day 3 after admission) [(15.1±1.8)], complication rate(52%), infection rate(8%), length of stay[(19.7±5.3)d] in 24 h group were all significantly lower than those of 72h group[(17.0±2.0), 72%, 32%, (25.4±6.8)d]and control group [(18.3±2.6), 84%, 44%, (38.7±12.6)d], and all the differences were statistically significant (all P<0.05). Conclusions Ultra EN supplemented with probiotics in treating the patients with SAP could significantly reduce the level of serum PCT, hs-CRP and endotoxin, decrease complication rate and mortality, and shorten the time of hospitalization. Key words: Pancreatitis, acute necrotizing; Probiotics; Enteral nutrition