重症急性胰腺炎的营养支持治疗

THE NUTRITIONAL SUPPORT FOR THE PATIENS WITH SEVERE ACUTE PANCREATITIS

目的研究不同营养途径对重症急性胰腺炎（SAP）病人营养及预后的影响。方法回顾性分析42例SAP病人,分为早期肠内营养（EEN组,n=21）及完全肠外营养（TPN组,n=21）。EEN组在入院后3-6 d均通过空肠营养管输注百普素（Pepti-2000variant）,两组予等热量、等氮量,总热量30 kcal/kg·d,氮量为0.17 g/kg·d。结果①EEN组死亡率低于TPN组,但无显著性差异（P〉0.05）,EEN组住院天数明显少于TPN组（P〈0.01）;②入院后2周：EEN组血红蛋白、体重高于TPN组,但无显著性差异;血浆总蛋白、白蛋白高于TPN组（P〈0.05）;前白蛋白明显高于TPN组（P〈0.01）。结论与TPN支持相对比,EEN可有效地改善SAP病人的营养状态,缩短住院时间。

Objective To compare the effects of early enteral nutrition （EEN） supportand total parenteral nutrition （TPN） support for the patiens with severe acute pancreatitis （SAP）. Methods 42 cases of SAP were studied restrospectively and the patiens were divided into two groups randomly：early enteral nutrition group（ EEN group, n = 21 ）, total parenteral nutrition group（TPN group, n=21 ）. Pepti-2000 was transfused through nasojejunal tube in the 3rd to the 6 th day after admission in EEN group. The calory and nitrogen in both groups were 30 kcal/kg·d and 0. 17 g/kg·d. Results①The death rate in the EEN group was lower than that in the TPN group, but there were no differences between two groups（P 〉 0.05） ;the hospitalized days in EEN group were less than that in the TPN group（P 〈 0.05）. ②In the two weeks after admission ：hemoglobin and body weight in EEN group were measured more than that in TPN group, but no significant difference was found;plasma total protein and albumin in EEN group were measured more than that in TPN group（ P 〈 0.05 ） ; and more prealbumin was found in EEN group. Conclusions Compared to TPN support, early EEN support is more efficient to improve body nutrition condition and shortens hospitalized days.