急性胰腺炎术后早期肠内营养疗效的观察及护理

Study on Effect Observation and Early Postoperative Enteric Nutrition Used for Patients with Acute Pancreatitis

目的探讨改善急性胰腺炎术后病人的营养状况和预后的措施。方法将30例急性胰腺炎术后病人随机分为2组,观察组(n=15)于术后2d行早期肠内营养,对照组(n=15)于术后7d行相对早期肠内营养,比较2组在周围静脉营养基础上行早期肠内营养后的疗效、相关并发症、营养液费用。结果观察组营养指标值优于对照组,差异有显著性(P<0.05),对早期肠内营养的耐受性比较示2组差异无显著性(P>0.05),有效且耐受性好的时机为术后5～7d,肠内肠外营养能量比为1/3:2/3,2组营养液及装置日平均费用差异无统计学意义。结论肠内肠外营养联合应用是维持能量平衡的最佳治疗措施,可避免由中心静脉补充营养途径,有效降低导管感染率和营养相关并发症。

Objective To explore the measurements of improving the postoperative nutrition status and prognosis of patients with acute pancreatitis. Methods 30 patients with acute pancreatitis were divided randomly into two groups. On the basis of peripheral vein nutrition, enteric nutrition was applied respectively on two days of postoperation in observation group（n = 15） and on seven days of postoperation in control group （n = 15）. The effect, relative complications and fee of nutrition liquid of two groups were compared. Results The nutriological parameters of observation group were better than those of control group and the difference was significant （P ＜ 0.05）. There was no significant difference between two groups in the tolerance of early enteric nutrition （P ＞ 0.05）. The popular and good tolerance time was 5 - 7 days after operation. The ratio of energy of intra - intestinal and extra -intestinal nutrition was 1/3： 2/3. There was no significant difference between two groups in the fee of nutrition liquid and apparatus every day. Conclusions The combination of intra - intestinal and extra - intestinal is the best method to keep the energy balance of body and can avoid supplying energy via central vein. Meanwhile, it can decrease the infection rate of tube and occurring rate of complications related to nutrition.