Репозиторий Университета

AIM: To develop and justify optimal nutritional support in early phase of acute pancreatitis (AP).MATERIAL AND METHODS: 140 AP patients were enrolled. They were divided into groups depending on nutritional support: group I (n=70) - early enteral tube feeding (ETF) with balanced mixtures, group II (n=30) - early ETF with oligopeptide mixture, group III (n=40) - total parenteral nutrition (TPN). The subgroups were also isolated depending on medication: A - Octreotide, B - Quamatel, C - Octreotide + Quamatel. Pancreatic secretion was evaluated by using of course of disease, instrumental methods, APUD-system hormone levels (secretin, cholecystokinin, somatostatin, vasointestinal peptide).RESULTS: ETF was followed by pancreas enlargement despite ongoing therapy, while TPN led to gradual reduction of pancreatic size up to normal values. α-amylase level progressively decreased in all groups, however in patients who underwent ETF (I and II) mean values of the enzyme were significantly higher compared with TPN (group III). Secretin, cholecystokinin and vasointestinal peptide were increasing in most cases, while the level of somatostatin was below normal in all groups.CONCLUSION: Enteral tube feeding (balanced and oligopeptide mixtures) contributes to pancreatic secretion compared with TPN, but this negative impact is eliminated by antisecretory therapy. Dual medication (Octreotide + Quamatel) is more preferable than monotherapy (Octreotide or Quamatel).

© 2018 Stavropol State Medical University. All rights reserved. Based on the indices of the functioning of the diffuse neuroendocrine system (DNES) of the digestive tract, the features of the formation of irritable bowel syndrome with extraintestinal manifestations are studied. We estimated the role of the endocrine cells of the mucous membrane of the sigmoid colon and the antrum of the stomach producing motilin (MT), vasointestinal hormone (VIH) and somatostatin (SS), in the onset and course of irritable bowel syndrome with extraintestinal manifestations. The relationship between the patient's psychological status, his neuroendocrine system and extraintestinal manifestations of the disease is demonstrated.