{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T15:45:17Z","timestamp":1760888717297},"reference-count":25,"publisher":"Akademiai Kiado Zrt.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MaSeb"],"published-print":{"date-parts":[[2012,4,1]]},"abstract":"<jats:title>Absztrakt<\/jats:title>\n        <jats:p>\n          <jats:italic>Bevezet\u00e9s:<\/jats:italic> A s\u00falyos acut pancreatitis a gastroenterologiai seb\u00e9szet nagy kih\u00edv\u00e1st jelent\u0151 ter\u00fclete. A leg\u00fajabb kutat\u00e1sok szerint a teljes parenteralis t\u00e1pl\u00e1l\u00e1s kieg\u00e9sz\u00edt\u00e9sek\u00e9nt intrav\u00e9n\u00e1san adott glutamin seg\u00edthet a septicus sz\u00f6v\u0151dm\u00e9nyek megel\u0151z\u00e9s\u00e9ben, \u00e9s cs\u00f6kkentheti a hal\u00e1loz\u00e1si r\u00e1t\u00e1t, azt azonban m\u00e9g nem vizsg\u00e1lt\u00e1k, vajon az enteralis t\u00e1pl\u00e1l\u00e1s eredm\u00e9nyeit is k\u00e9pes-e jav\u00edtani a glutamin. <jats:italic>C\u00e9lkit\u0171z\u00e9s:<\/jats:italic> A korai jejunalis t\u00e1pl\u00e1l\u00e1s \u00e9s az intrav\u00e9n\u00e1s glutamin-dipeptid egy\u00fcttes alkalmaz\u00e1s\u00e1nak vizsg\u00e1lata s\u00falyos acut pancreatitisben, prospekt\u00edv randomiz\u00e1lt kett\u0151s vak kontroll\u00e1lt klinikai vizsg\u00e1lat sor\u00e1n. <jats:italic>Beteganyag \u00e9s m\u00f3dszerek:<\/jats:italic> Vizsg\u00e1latunkban 45 s\u00falyos acut pancreatitis miatt kezelt beteg vett r\u00e9szt, akikn\u00e9l felv\u00e9telkor a Glasgow score legal\u00e1bb 3 volt, \u00e9s\/vagy a CRP 150 mg\/ml feletti. A glutamincsoport (<jats:italic>n<\/jats:italic> = 24) tagjai napi 0,5 g\/kg i.v. glutamint, a kontrollcsoport (<jats:italic>n<\/jats:italic> = 21) tagjai azonos mennyis\u00e9gben a k\u00f3rh\u00e1zi gyakorlatban alkalmazott, egy\u00e9b aminosavakb\u00f3l \u00e1ll\u00f3 inf\u00fazi\u00f3t kaptak 7 napig. A felv\u00e9telt k\u00f6vet\u0151 48 \u00f3r\u00e1n bel\u00fcl minden betegn\u00e9l elkezdt\u00fck a nasojejunalis t\u00e1pl\u00e1l\u00e1st, \u00e9s kezel\u00e9s\u00fck minden egy\u00e9b szempontb\u00f3l is azonos ir\u00e1nyelvek szerint t\u00f6rt\u00e9nt. A vizsg\u00e1lat els\u0151dleges v\u00e9gpontjak\u00e9nt a pancreasspecifikus septicus sz\u00f6v\u0151dm\u00e9nyek \u00e9s a szervi el\u00e9gtelens\u00e9gek gyakoris\u00e1g\u00e1t, m\u00e1sodlagos v\u00e9gpontokk\u00e9nt a radiol\u00f3giai \u00e9s seb\u00e9szeti intervenci\u00f3k sz\u00fcks\u00e9gess\u00e9g\u00e9t, a k\u00f3rh\u00e1zi tart\u00f3zkod\u00e1s id\u0151tartam\u00e1t \u00e9s a mortalit\u00e1st jel\u00f6lt\u00fck meg. <jats:italic>Eredm\u00e9nyek:<\/jats:italic> A glutamincsoportban 4 betegn\u00e9l alakult ki fert\u0151z\u00f6tt acut peripancreaticus folyad\u00e9kgy\u00fclem, 2 betegn\u00e9l fert\u0151z\u00f6tt postnecroticus folyad\u00e9kgy\u00fclem, 2 esetben fert\u0151z\u00f6tt pseudocysta \u00e9s 2 betegn\u00e9l fert\u0151z\u00f6tt necrosis. T\u00edz esetben UH-, illetve CT-vez\u00e9relt punkci\u00f3val \u00e9s drainage-zsal siker\u00fclt megsz\u00fcntetni a folyad\u00e9kgy\u00fclemet, m\u0171t\u00e9tre egy betegn\u00e9l sem volt sz\u00fcks\u00e9g. A kontrollcsoportban 4 betegn\u00e9l alakult ki fert\u0151z\u00f6tt acut peripancreaticus folyad\u00e9kgy\u00fclem, 2 betegn\u00e9l fert\u0151z\u00f6tt postnecroticus folyad\u00e9kgy\u00fclem, 3 esetben fert\u0151z\u00f6tt pseudocysta \u00e9s 3 esetben fert\u0151z\u00f6tt necrosis. Kilenc esetben sikeres volt a radiol\u00f3giai intervenci\u00f3, h\u00e1rom betegn\u00e9l seb\u00e9szi beavatkoz\u00e1sra k\u00e9nyszer\u00fclt\u00fcnk. A kontrollcsoport mortalit\u00e1sa 14% (3 beteg) volt, szemben a glutamincsoport 0%-os mortalit\u00e1s\u00e1val. A glutamincsoport \u00e1tlagos \u00e1pol\u00e1si ideje 10,6 nap volt, ami szignifik\u00e1nsan r\u00f6videbb a kontrollcsoport 15,9 napj\u00e1n\u00e1l (<jats:italic>p<\/jats:italic> = 0,00104). <jats:italic>\u00d6sszefoglal\u00e1s:<\/jats:italic> A glutamincsoport eredm\u00e9nyei minden vizsg\u00e1lt param\u00e9ter eset\u00e9n valamivel jobbnak bizonyultak a kontrollcsoport\u00e9in\u00e1l, de statisztikailag kimutathat\u00f3 k\u00fcl\u00f6nbs\u00e9get csak az \u00e1pol\u00e1si napok sz\u00e1m\u00e1ban siker\u00fclt igazolni.<\/jats:p>","DOI":"10.1556\/maseb.65.2012.2.2","type":"journal-article","created":{"date-parts":[[2012,4,19]],"date-time":"2012-04-19T01:13:24Z","timestamp":1334798004000},"page":"44-51","source":"Crossref","is-referenced-by-count":11,"title":["Intrav\u00e9n\u00e1s glutamin \u00e9s korai nasojejunalis t\u00e1pl\u00e1l\u00e1s egy\u00fcttes alkalmaz\u00e1sa s\u00falyos acut pancreatitisben \u2013 prospekt\u00edv randomiz\u00e1lt kett\u0151s vak kontroll\u00e1lt 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