The clinical effect of the early enteral nutrition combined with glutamine and arginine in severe acute pancreatitis

Objective To compare the effect of early enteral nutrition combined with glutamine and arginine and early standard enteral nutrition on the inflammatory response and prognosis of severe acute pancreatitis.Methods A total of 44 patients with severe acute pancreatitis were randomized divided into two groups:the observation group(n=22) was treated with early enteral nutrition combined with glutamine and arginine,while the control group(n=22) was treated with early standard enteral nutrition.The general conditions and severity of the disease were similar in both groups.All the patients were treated with gastrointestinal decompression,fluid palinesthesia and so on after hospitalization.Two groups were fed by an endoscopically placed naso-gastrojejunal tube or stoma within 7 days.The formula of the observation group was early enteral nutrition combined with glutamine and arginine,while the control group was standard enteral nutrition.The course of treatment was 30 days.After the course,the formula of all patients was enteral nutrition with whole protein,or some patients were operated according to their actuality.The markers of inflammatory response and the change of the nutrition indicators were observed,meanwhile,the incidence of complication in inflammation and the fatality were compared.Results One inpatient was dead in early enteral nutrition combined with glutamine and arginine,while two inpatients were dead in control group.Infected pancreatic necrosis and abscess occurrence rates were significantly different(P0.05).There was remarkable decrease in cAMP receptor protein and amount of leucocyte in both groups(P0.05),while blood platelets count was significantly increased,the difference heing remarkably different(P0.01).There was significant difference on hospital stay in both groups(P0.05).Conclusions It is suggested that the early enteral nutrition combined with glutamine and arginine and common enteral nutrition are equally effective to the patients with severe acute pancreastitis on alleviating inflammatory response,ameliorating nutritional state.However,the early enteral nutrition combined with glutamine and arginine is more efficient than the early standardized enteral nutrition in preventing secondary infection of the patients.