营养支持在胰源性腹水治疗中的应用(附1例报告及文献总结)

The use of nutritional support in treating pancreatic ascites

目的:观察营养支持在胰源性腹水治疗中的作用。方法:对1例慢性胰腺炎合并Odd i括约肌炎性狭窄引起的胰源性腹水病人,在一般治疗的基础上,采取肠外营养2周,腹水消退后,行胆道下端扩张和胆道引流手术。术后行肠内营养2周。在肠外营养前后,观察腹水引流量和血清清蛋白水平的变化。结果:经过肠外营养支持,腹水引流量迅速减少,1周时消退,血清清蛋白水平明显升高。术后肠内营养改善了营养状态。结论:在胰源性腹水治疗中,肠外营养能让胰腺休息,促进腹水消退,减少蛋白质丢失,提高血清清蛋白水平;肠内营养更能有效地改善营养状态。

Objective： To observe the role of nutritional support in treating pancreatic ascites. Methods： Nutritional support was used in a patient with pancreatic aseites caused by chronic panereatitis complicated with distal common bile duct stricture. Parenteral nutrition was used for two weeks. After ascites disappeared, an operation was performed for the distal common bile duct stricture. Enteral nutrition via naso-jejunal feeding tube was used for two weeks after the operation. Output of aseites was daily measured from the drainage catheter of abdominal cavity before and after parenteral nutrition. Plasma albumin concentration was determined. Results： Ascites disappeared rapidly and plasma albumin level was increased one week after the use of parenteral nutrition. The patient underwent the operation smoothly and without any complication. Postoperative enteral nutrition improved the nutritional status effectively. Conclusion ： Nutritional support is very useful in the treatment of pancreatic aseites. Parenteral nutrition can keep the gastrointestinal tract and pancreas at rest and promote the disappearance of pancreatic ascites rapidly with the decrease of protein loss and the increase of plasma albumin level. Postoperative enteral nutrition can effectively improve the nutritional status.