早期肠内营养在重症急性胰腺炎中的应用

Early Enteral Nutrition in Patients with Severe Acute Pancreatitis Application

目的探讨重症急性胰腺炎患者早期实施肠内营养（EN）的安全性、可行性及有效性。方法本组38例患者分为48小时开始EN的早期组和7天开始EN的后期组，均经采用荷兰纽迪西亚制药有限公司生产的螺旋式鼻空肠管，鼻空肠管置入采用常规置入法、X线引导或胃镜辅助置入法持续滴注肠内营养液，并由肠外营养逐步过度到EN。测定两组患者的耐受性指标（血淀粉酶、血糖及肝功能）、有效指标（血浆白蛋白）并观察临床症状：有无腹痛及腹部体征。结果耐受性指标两组均在正常范围，而有效性指标提示早期组的血浆白蛋白值升高较快、低蛋白血症的纠正比后期组早，两组均无腹痛等现象。结论提示重症急性胰腺炎患者早期实施EN是安全、可行和有效的，它能提高治愈率，在治疗中起到重要的作用。

Objective Summary of patients with severe acute pancreatitis early implementation of enteral nutrition （EN） the safety, feasibility and effectiveness. Methods This group of 38 cases were divided into 48 hours beginning early EN group and the seven days beginning of the late EN group, have been used Helanniu DiXiYa Pharmaceuticals Limited production of spiral nose jejunum tube, nose jejunum tube placement using conventional home the method, X-ray guidance or endoscOpy-assisted implantation of continuous infusion of enteral nutrition and parenteral nutrition gradually over by the EN. In group 2 patients tolerance parameters （blood amylase, blood sugar and liver function）, effective indicators （plasma albumin）, and observation of clinical symptoms： abdominal pain and abdominal signs there. Results tolerance indicators 2 groups were in the normal range, and effectiveness of the early indicators suggested that the Group of plasma albumin values increased faster, hypoproteinemia corrected earlier than the late group, the two groups had no abdominal pain, and other phenomena. Conclusion In patients with severe acute pancreatitis suggested that the early implementation of EN is safe, feasible and effective, it can improve the cure rate in the treatment play an important role.