重症急性胰腺炎早期肠内营养支持体会

Experience of Early Enteral Nutrition in Severe Acute Pancreatitis

目的探讨重症胰腺炎患者早期肠内营养体会。方法回顾性分析86例重症急性胰腺炎患者营养支持治疗经过。结果全胃肠外营养(TPN)组(40例)持续营养支持时间平均为(25.58±3.84)d,胰腺和周组织感染率达33.3%。全胃肠外营养+肠内营养(TPN+EN)组(46例)的营养支持时间平均为(17.58±4.2)d,胰腺和胰周组织的感染率为17.3%,5例(10%)的胰腺炎有反弹,无患者死亡。与TPN组比较,TPN+EN组营养支持时间短,住院天数少,平均住院费用低,感染性并发症率低,治疗后前清蛋白和清蛋白值高,差异均有统计学意义(P<0.05)。结论重症胰腺炎患者在肠功能恢复后早期行肠内营养支持,有利于维护肠屏障功能,降低胰腺炎并发症及提高其治愈率。

Objective To investigate the experience of early enteral nutrition in patients with severe acute pancreatitis. Methods The data of nutritional support in 86 cases with severe acute pancreatitis were analyzed retrospectively,40 cases were conducted by total parenteral nutrition only （TPN group） and 46 cases were performed by total parenteral nutrition and enteral nutrition （TPN ＋ EN group）. Results The average time of continued nutritional support was （25.58 ± 3.84 ） days in TPN group（40 cases）and their infection rate iu pancreas and peripancreatic tissues was 33.3 %. Meanwhile, the average time of continued nutritional support was （ 17.58 ± 4.2） days,the infection rate was 17.3% in TPN ＋ EN group,and five cases （10%） of pancreatitis have a rebound and no mortality. Compared with those in TPN group ,the average nutritional support time, the hospitalization time mean hospitalization costs, and the infection rates were lower after treatment, while the levels of prealburnin and albumin were higher significantly （ P 〈 0. 05 ）. Conclusion Early enteral nutrition support of the patients with severe pancreatitis after intestinal function recovery should be helpful to maintain intestinal barrier function and reduce complications of pancreatitis and improve its cure rate.