Analysis of preventive effect and influencing factors of early enteral nutrition and microecological immune enteral nutrition on renal injury in patients with severe acute pancreatitis
Objective To analyze the preventive effects of early enteral nutrition and microecological immune enteral nutrition on renal injury in patients with severe acute pancreatitis(SAP),and to explore the risk factors affecting renal injury in patients.Methods A total of 296 patients with SAP admitted to Huai'an First People's Hospital from January 2020 to December 2022 were randomly divided into combined group(n=148)and control group(n=148).Both groups received routine treatment and early enteral nutrition support,while the combined group received staged microecological immune enteral nutrition support.The incidence of renal injury was compared between the two groups,and the clinical data and nutritional support programs of patients with and without renal injury were compared.Logistic regression model was used to summarize the risk factors related to renal injury.Results After 7 days of intervention,the total protein,albumin,prealbumin and transferrin in the two groups were higher than those before intervention,while those in the combined group were higher than those in the control group after 7 days of intervention(P<0.05).The incidence of renal injury in the combined group was 22.30%(33/148),which was lower than that in the control group(36.49%,54/148),with statistically significant difference(χ2=7.179,P<0.05).Multivariate regression analysis showed that age,APACHE Ⅱscore,C-reactive protein and cystatin C,as well as CT grade E,diabetes,mechanical ventilation and shock were all independent risk factors for renal injury in SAP patients,and microecological immune enteral nutrition was the protective factor(P<0.05).Conclusion The nutritional status of SAP patients is generally poor,and the nutritional status is improved more obviously after receiving microecological immune enteral nutrition support than simple enteral nutrition support,and the risk of renal injury is also reduced.At the same time,the occurrence of renal injury in SAP patients is also related to baseline characteristics such as age,severity of illness,severity of inflammatory reaction and complications.
Severe acute pancreatitisEnteral nutritionMicroecological immunityRenal injuryInfluencing factor
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