Objective  To investigate the effects of probiotic treatment combined with knowledge attitude and practice (KAP) model management on the recovery and quality of life of patients with severe acute pancreatitis.

Methods  Patients with severe acute pancreatitis from June 2020 to June 2023 in Quzhou People's Hospital were selected. The patients were divided into the control group, the probiotics group and the KAP combination group. All groups received symptomatic treatment. The control group was given routine nursing, the probiotic group was given daily oral administration of probiotic granules, and the KAP combination group was managed by KAP model on the basis of probiotic treatment, including targeted intervention in the dimensions of disease knowledge, behavior and belief. The APACHE II scores, quality of life scale QOL-C30 scores, serum inflammatory factors C-reactive protein (CRP) and procalcitonin (PCT) levels were compared before and after treatment in three groups.

Results  A total of 108 patients were included, with 36 cases in each group. The CRP and PCT decreased significantly after treatment in three groups (P<0.05). The reduction ranges of the probiotics group and the KAP group were significantly higher than that of the control group (P<0.05). The self-management ability was significantly increased in all three groups after treatment compared to before treatment (P<0.05), and the increase was significantly greater in the KAP combination treatment group than in the probiotic and control groups (P<0.05). The APACHE II scores decreased significantly and QOL-C30 scores increased significantly after treatment in the probiotics group and the KAP group (P<0.05).

Conclusion  Probiotic treatment could significantly improve the inflammatory status, clinical symptoms and quality of life of patients with severe acute pancreatitis. The KAP model management could further enhance the effect of probiotic treatment, effectively improve patients’ organism recovery ability and quality of life.

1.Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review[J]. Pancreas, 2006, 33(4): 323-330. DOI: 10.1097/01.mpa. 0000236733.31617.52.

2.何海涛, 周泽, 魏志力, 等. 糖皮质激素对急性重症胰腺炎患者预后及炎症指标的影响[J]. 中国药师, 2023, 26(12): 435-441. [He HT, Zhou Z, Wei ZL, et al. The effect of glucocorticoids on prognosis and inflammatory markers in patients with severe acute pancreatitis[J]. China Pharmacist, 2023, 26(12): 435-441.] DOI: 10.12173/j. issn.1008-049X.202311196.

3.Bengmark S. Bio-ecological control of acute pancreatitis: the role of enteral nutrition, pro and synbiotics[J]. Curr Opin Clini Nutr Metab Care, 2005, 8(5): 557-561. DOI: 10.1097/01.mco.0000170758. 78737.90.

4.Shah AP, Mourad MM, Bramhall SR. Acute pancreatitis: current perspectives on diagnosis and management[J]. J Inflam Res, 2018, 11: 77-85. DOI: 10.2147/JIR.S135751.

5.Wen W, Zheng H, Jiang Y, et al. Effect of intestinal epithelial autophagy on bacterial translocation in severe acute pancreatitis[J]. Clin Res Hepatol Gastroenterol, 2017, 41(6): 703-710. DOI: 10. 1016/j.clinre.2017.03.007.

6.Huang L, Jiang Y, Sun Z, et al. Autophagy strengthens intestinal mucosal barrier by attenuating oxidative stress in severe acute pancreatitis[J]. Dig Dis Sci, 2018, 63(4): 910-919. DOI: 10.1007/s10620-018-4962-2.

7.Salgaço MK, Oliveira LGS, Costa GN, et al. Relationship between gut microbiota, probiotics, and type 2 diabetes mellitus[J]. App Microbiol Biotechnol, 2019, 103(23-24): 9229-9238. DOI: 10.1007/s00253-019-10156-y.

8.Werge M, Novovic S, Schmidt PN, et al. Infection increases mortality in necrotizing pancreatitis: A systematic review and meta-analysis[J]. Pancreatology, 2016, 16(5): 698-707. DOI: 10.1016/j.pan.2016.07.004.

9.Guo Q, Li A, Xia Q, et al. The role of organ failure and infection in necrotizing pancreatitis: a prospective study[J]. Ann Surg, 2014, 259(6): 1201-1207. DOI: 10.1097/SLA. 0000000000000264.

10.吕晋红, 李晓丽. 益生菌辅助治疗重症急性胰腺炎的研究进展[J]. 安徽医药, 2024, 28(2): 217-220. [Lyu JH, Li XL. Research progress on probiotic assisted therapy for severe acute pancreatitis[J]. Anhui Medicine, 2024, 28(2): 217-220.] DOI: 10.3969/j. issn.1009-6469.2024.02.002.

11.江盼盼, 徐影, 王凯寒. 多学科协作护理联合延续护理在重症急性胰腺炎患者中的应用[J]. 临床医学工 程, 2023, 30(3): 389-390. [Jiang PP, Xu Y, Wang KH. The application of multidisciplinary collaborative nursing combined with continuing care in patients with severe acute pancreatitis[J]. Clinical Medical Engineering, 2023, 30(3): 389-390.] DOI: 10.3969/j. issn.1674-4659.2023.03.0389.

12.任会鹏, 周爽, 刘晓娜, 等. 精神分裂症患者一级亲属的事件相关电位及与神经认知功能的相关性[J]. 中国心理卫生杂志, 2023, 37(3): 227-232. [Ren HP, Zhou S, Liu XN, et al. Event related potentials and their correlation with neurocognitive function in first-degree relatives of patients with schizophrenia[J]. Chinese Journal of Mental Health, 2023, 37(3): 227-232] DOI: 10.3969/j.issn. 1000-6729.2023.03.007.

13.李非, 曹锋. 中国急性胰腺炎诊治指南（2021）[J]. 中国实用外科杂志, 2021, 41(7): 739-746. [Li F, Cao F. Chinese guidelines for the diagnosis and treatment of acute pancreatitis (2021)[J]. Chinese Journal of Practical Surgery, 2021, 41(7): 739-746.] DOI: 10.19538/j.cjps.issn1005-2208.2021.07.03.

14.薛彩虹, 孙黎惠, 单信芝, 等. 急性胰腺炎基于知信行模式的健康教育评价指标体系的初步构建[J]. 护理研 究, 2017, 31(7): 816-819. [Xue CH, Sun LH, Shan XZ, et al. Preliminary construction of health education evaluation index system based on knowing, believing and doing model in acute pancreatitis[J]. Nursing Research, 2017, 31(7): 816-819.] DOI: 10.3969/j.issn.1009- 6493.2017.07.014.

15.Mederos MA, Reber HA, Girgis MD. Acute pancreatitis: a review[J]. JAMA, 2021, 325(4): 382-390. DOI: 10.1001/jama.2020.20317.

16.Perrone F, Jommi C, Di Maio M, et al. The association of financial difficulties with clinical outcomes in cancer patients: secondary analysis of 16 academic prospective clinical trials conducted in Italy[J]. Ann Oncol, 2016, 27(12): 2224-2229. DOI: 10.1093/annonc /mdw433.

17.晁蕊停, 杨秀娟, 申敏, 等. 知信行模式干预在卵巢癌术后患者中的应用效果[J]. 癌症进展, 2023, 21(5): 531-534. [Chao RT, Yang XJ, Shen M, et al. The application effect of knowledge, belief, and action model intervention in postoperative patients with ovarian cancer[J]. Cancer Progression, 2023, 21(5): 531-534.] DOI: 10.11877/j. issn.1672-1535.2023.21.05.17.

18.高云珠, 薛少芳, 叶小燕, 等. KAP护理模式对结直肠癌患者术后睡眠质量及并发症的影响分析[J]. 世界睡眠医学杂志, 2023, 10(7): 1664-1666. [Gao YZ, Xue SF, Ye XY, et al. Analysis of the impact of KAP nursing model on postoperative sleep quality and complications in patients with colorectal cancer[J]. World Journal of Sleep Medicine, 2023, 10(7): 1664-1666.] DOI: 10.3969/j. issn. 2095-7130.2023.07.065.

19.Malik A, Amjad W, Farooq U, et al. Evaluation of the effect of probiotics on septic complications in patients with severe acute pancreatitis. a systematic review and meta-analysis[J]. Prz Gastroenterol, 2023, 18(3): 281-291. DOI: 10.5114/pg.2022.118164.

20.吕彦青, 李嘉杰, 刘坤禹, 等. 急性胰腺炎患者肠道菌群变化及益生菌的应用[J]. 临床肝胆病杂志, 2023, 39(12): 2970-2977. [Lyu YQ, Li JJ, Liu KY, et al. Changes of intestinal flora and application of probiotics in patients with acute pancreatitis[J]. Journal of Clinical Hepatobiliary Diseases, 2023, 39(12): 2970-2977.] DOI: 10.3969/j.issn. 1001-5256.2023.12.033.

21.黄乔, 蒙钊, 李媛. 益生菌联合谷氨酰胺对重症急性胰腺炎患者肠道菌群变化、血清炎性因子及胃肠功能的影响[J]. 中国煤炭工业医学杂志, 2020, 23(1): 86-89. [Huang Q, Meng Z, Li Y. Effects of probiotics combined with glutamine on intestinal flora changes, serum inflammatory factors and gastrointestinal function in patients with severe acute pancreatitis[J]. China Coal Industry Medical Journal, 2020, 23(1): 86-89.] DOI: 10.11723/mtgyyx 1007-9564 202001019.

22.冯殿秀. 益生菌调节肠道菌群治疗重症急性胰腺炎的临床应用进展[J]. 现代诊断与治疗, 2023, 34(1): 32-34, 37. [Feng DX. Progress of clinical application of probiotics to regulate intestinal flora in the treatment of severe acute pancreatitis[J]. Modern Diagnosis and Treatment, 2023, 34(1): 32-34, 37.] https://xueshu.baidu.com/usercenter/paper/show?paperid=1s460re0xn090rf0dx7p0620e8212574&site=xueshu_se&hitarticle=1.

23.Gu WJ, Liu JC. Probiotics in patients with severe acute pancreatitis[J]. Crit Care, 2014, 18(4): 446. DOI: 10.1186/cc13968.

24.吴柳蓉, 卢巧艳, 林淑霞. KAP教育模式对急性胰腺炎自我管理及生活质量影响 [J]. 西藏医药, 2023, 44(5): 98-100. [Wu LR, Lu QY, Lin SX. Effect of KAP education model on self-management and quality of life in acute pancreatitis [J]. Tibetan Medicine, 2023, 44(5): 98-100.] https://xueshu.baidu.com/usercenter/paper/show?paperid=101x0tb0gj4u0c007f3g08k08q149666&site=xueshu_se&hitarticle=1.

25.Xiong S, Ding M, Li P, et al. A health education model based on knowledge, attitude, and  practice used as adjunct therapy for metabolic syndrome complicated with acute pancreatitis: A case report[J]. The Journal of International Medical Research, 2020, 48(5): 300060520924272. DOI: 10.1177/0300060520924272.