Curative Effect Observation Of Composite Probiotics In Patients With Acute Pancreatitis

ObjectiveTo explore curative effect of composite probiotic in patients with acute pancreatitis（AP）.MethodsCollected106cases diagnosed patients with acute pancreatitis from February2012to October2013in Yan’an University Affiliated Hospital.(1)106AP patients was divided into78cases of patients with mild acutepancreatitis （MAP）and28cases of patients with severe acute pancreatitis（SAP）.TheMAP patients were randomly divided into probiotics treatment group in29cases andcontrol group in49cases; SAP patients were randomly divided into probiotics treatmentgroup in12cases and control group in16cases. The control group were givenconventional treatment,including fasting, gastrointestinal decompression, inhibition ofpancreatic enzymes and gastric acid secretion, improve microcirculation, acetanilidespasmolysis, maintaining water and electrolyte balance, prevent infection andcomplications; Probiotics treatment group on the basis of conventional treatment，combined with bifidobacterium quadruple living bacterium within48-72hours after theonset of AP. Comparison of abdominal pain relief time, blood amylase returned tonormal time, time to take food, hospitalization time, infection rate, incidence ofincomplete intestinal obstruction, SIRS or MODS incidence and mortality in two groups. (2)101AP patients were divided into48cases of acute gallstone pancreatitis,30cases of pancreatitis caused by drinking or overeating,23cases of hyperlipidemia. Acutegallstone pancreatitis were randomly divided into21cases of probiotics treatment groupand27cases of control group; Pancreatitis caused by drinking or overeating wererandomly divided into12cases of probiotics treatment group and18cases of controlgroup; Hyperlipidemic acute pancreatitis were randomly divided into9cases ofprobiotics treatment group and14cases of control group. The control group were givenconventional treatment,including fasting, gastrointestinal decompression, inhibition ofpancreatic enzymes and gastric acid secretion, improve microcirculation, acetanilidespasmolysis, maintaining water and electrolyte balance, prevent infection andcomplications; Probiotics treatment group on the basis of conventional treatment，combined with bifidobacterium quadruple living bacterium within48-72hours after theonset of AP. Comparison of abdominal pain relief time, blood amylase returned tonormal time, time to take food, hospitalization time, infection rate, incidence ofincomplete intestinal obstruction, SIRS or MODS incidence and mortality in two groups.Results(1) The curative effect observation of composite probiotics in patients with differentseverity acute pancreatitis:For MAP, there was no statistical significance about abdominal pain relief time,blood AMY back to normal time, time to take food, hospital stay, infection rate,incidence of incomplete intestinal obstruction, SIRS or MODS incidence, mortality inprobiotics treatment group and control group (P>0.05).For SAP, probiotics treatment group, abdominal pain relief time, time to take food,hospitalization time, infection rate, incidence of incomplete intestinal obstruction, SIRSor MODS incidence were lower than the control group, two groups had statisticaldifference (P <0.05);Blood AMY back to normal time, mortality had no statisticalsignificance in two groups (P>0.05). (2) The curative effect observation of composite probiotics in patients with differentetiology acute pancreatitis:For gallstone pancreatitis, probiotics treatment group abdominal pain relief time,blood AMY back to normal time, time to take food, length of hospital stay were lowerthan the control group, two groups had statistical difference (P <0.05); Infection rate,incidence of incomplete intestinal obstruction, SIRS or MODS incidence, mortality hadno statistical difference in two groups (P>0.05).For pancreatitis caused by drinking or overeating, probiotics treatment groupabdominal pain relief, blood AMY back to normal time, time to take food, length ofhospital stay incidence of incomplete intestinal obstruction were lower than the controlgroup, two groups had statistical difference (P <0.05); Infection rates, SIRS and MODSincidence and mortality in the two groups had no statistical difference (P>0.05).For hyperlipidemic pancreatitis, probiotics treatment group open abdominal painrelief time, time to take food, length of hospital stay, the incidence of incompleteintestinal obstruction, lower than the control group, two groups had statistical difference(P <0.05); Blood AMY back to normal time, infection rate, incidence of SIRS andMODS and mortality，there was no statistical difference in the two groups (P>0.05).Conclusion1There was no obvious improvement of course and prognosis about probiotics inpatients with MAP.2Probiotics can improve the course and prognosis of SAP patients, shorten the timeof abdominal pain and reduce the complications.3For different etiology of acute pancreatitis, probiotics can improve the clinicalcourse of patients, shorten the abdominal pain relief time, and hospital stay, but theintercurrent infection, incidence of SIRS and MODS and mortality rate have no obviousimprovement.4Probiotics can reduce the incidence of intestinal obstruction, prompt probioticscan improve intestinal impetus of acute pancreatitis, reduce intestinal pathogenic bacteriaaccumulate, thus reducing the occurrence of bacterial translocation. 5There was no obvious improvement of mortality about probiotics in acutepancreatitis.