谷氨酰胺对重症胰腺炎患者营养状况的影响.doc

谷氨酰胺对重症胰腺炎患者营养状况的影响 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：谷氨酰胺对重症胰腺炎患者营养状况的影响 1 1 资料和方法 3 1．1 一般资料 3 1．2 方法 3 13 统计学方法 4 2 结果 4 2．2 两组患者住院情况以及病死率比较 4 3 讨论 4 3．1 重症胰腺炎的营养支持特点 4 3．2 谷氨酰胺在ASP治疗中的作用 5 文2：谷氨酰胺对慢性阻塞性肺疾病呼吸衰竭机械通气患者营养状况及免疫功能的影响 6 1临床资料 7 参考文摘引言： 9 原创性声明（模板） 10 文章致谢（模板） 11 正文 谷氨酰胺对重症胰腺炎患者营养状况的影响 文1：谷氨酰胺对重症胰腺炎患者营养状况的影响 Effect of Glutamine on Nutrition State in Severe Acutc Pancreatitis Abstract： Objective To observe the effect of glutamine on nutrition in severeacute pancreatitis (SAP). Methods Fortyone SAP patients was divided into two groups at random: there were 21 patients in routine TPN group and 20 ones in TPN+glutamine group. The concentratio of serum albumin and traferrin, and body mass were observed. Results The concentratio of serum albumin in TPN group and TPN+glutanine group were respectively (±) g/L and (±) g/L at the beginning of hospita1ization. After two weeks treatment, they became (±4. 62) and (±)g/L. Body mass at the beginning of hospitalization were (±) kg and (±) kg. After two weeks treatment they became (±14. 63) and (±) kg, respectively. The concentratio of traferrin were (±0. 7)g/L and (±0. 4) g/L at fit, and became (±) and (±)g/L two weeks later. There were significantly statistical differences between the two groups in the concentratio of serum album and traferrin, and body mass. Conclusion Glutamine can improve the nutrition state of the patients with SAP in addition to TPN therapy. Also, it can reduce the mortality and morbidity of complicatio. Key words： severe acute pancreatitis; total paraenteral nutrition; glutamine 重症胰腺炎（SAP）是消化内科一种常见的急性、全身消耗性危重疾病，除了胰腺本身的一系列病理生理改变外，常伴有全身炎症反应和多器官损伤，虽然在诊断、监护以及治疗上已经取得了许多的进展，但死亡率仍然达10%~20%[1]，SAP患者死亡时间有两个高峰期，第1个高峰在疾病的第1周，死亡原因主要是全身过度的炎症反应（SI）和全身多器官功能障碍（MODS），第2个死亡高峰期是疾病的2~3周，主要原因为胰腺以及胰周的感染引起的脓毒症，目前对于重症胰腺炎的治疗主张早期以非手术治疗为主，SAP患者多数伴有腹胀，呕吐等症状，早期进食会刺激胰腺的分泌，加重胰腺的自身消化，给予TPN是早期治疗SAP的重要的手段之一，我科在TPN的基础上加用N（2）L丙胺酸L谷氨酰胺（力太）治疗SAP20例，以评价谷氨酰胺对重症胰腺炎营养状况的影响，现将结果报告