胰腺炎儿童的非常早期和早期营养-一项随机试验
Jan S Bukowski1, Tatiana Jamer2, Kinga Kowalska-Duplaga3
1Department of Paediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.
Journal of pediatric gastroenterology and nutrition
|June 28, 2024
概括
对于患有轻度急性胰腺炎 (AP) 的儿童,在24小时内引入再食并没有改变住院时间或炎症标志物. 儿科AP的早期营养与延迟的再养相比,没有显著的临床或实验室益处.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 临床营养学 临床营养学
- 炎症性疾病 炎症性疾病
背景情况:
- 儿童急性胰腺炎 (AP) 需要谨慎的营养管理.
- 在儿科AP中启动再食的最佳时间仍在争论中.
- 早期营养支持旨在预防营养不良,调节炎症反应.
研究的目的:
- 评估非常早期 (在24小时内) 重新养对儿科AP的临床过程的影响.
- 评估早期营养对AP儿童的炎症标记物,包括细胞因子的影响.
主要方法:
- 一项前性随机研究,涉及75名儿童 (年龄在1-18岁) 在波兰三个大学医院中轻度AP.
- 患者被随机分为两组:非常早期的再养 (24小时内) 和早期的再养 (入院后至少24小时).
- 在住院的前三天测量血清细胞因子度 (TNF-α,IL-1β,IL-6,IL-8),C反应蛋白,氨基酶,脂酶和氨基转移酶.
主要成果:
- 对于住院时间,AP症状或大多数实验室检测结果,两组之间没有显著差异.
- 64名儿童的细胞因子水平分析没有显示出任何显著差异,除了在一组 (p=0.01) 的第三天对IL-1β的统计显著增加外.
- 该研究包括75名患有轻度胰腺炎的患者,其中42名在非常早期的再养组中,33名在早期的再养组中.
结论:
- 在轻度AP的儿童中,在24小时内开始口服营养,而在24小时后开始口服营养,不会显著影响住院时间或症状发生.
- 非常早期的再食并没有在调节关键炎症标志物如TNF-α,IL-1β,IL-6和IL-8方面显示出明显的优势.
- 目前的证据表明,在轻度儿科AP中重新养的时间可能对临床结果或炎症反应不至关重要.
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