早期肠内营养在重症急性胰腺炎治疗中的作用

The observation of effects of early enteral nutriton on severe acute pancreatitis

目的探讨重症急性胰腺炎早期肠内营养的可行性、安全性及有效性。方法将我院40例重症急性胰腺炎病人,随机分成肠内营养组(EN)(20例)和对照组(20例),EN组在入院72h后在胃镜辅助下置空肠营养管,由肠外营养逐渐过渡到肠内营养,其余治疗与对照组相同。分别比较两组治疗后7天时的血浆白蛋白和血红蛋白水平,以及治疗前后血尿淀粉酶水平。结果所有病人对早期肠内营养都能耐受,无胰腺炎复发,肠内营养对血尿淀粉酶无明显影响,EN组血浆白蛋白和血红蛋白水平较治疗前及对照组有显著提高,EN组有1例出现肺感染,2例并发胰腺假性囊肿。对照组有3例出现肺感染,2例并发胰腺假性囊肿。结论对重症急性胰腺炎进行早期肠内营养支持是可行、安全及有效的,能降低胰周及全身感染率,改善重症急性胰腺炎病人的营养状况。

Objective To explore the feasibility, safty and validity of early enteral nutrition （EN） in severe acute pancreatitis （SAP）. Method Forty patients with SAP were randomly allocated to either EN group （20 patients） or control group （20 patients）. Patients in EN group were placed nutrition tubes into the jejunum by gastroscopy within 72 hours of admission, the nutrition support was performed from parenteral to enteral route gradually, and other treatments were as same as in control group. Serum albumin and hemoglobin, serum and urinary amylase were determined before and after 7 day treatment. Result All patients could endure the early EN, and no recurrence of SAP was found. The serum and urinary amylase were not changed significantly; serum albumin and hemoglobin level were higher in EN group. One patient was complicated with lung infection, and 2 patients with pseudocyst. Conclusion Enteral nutrition is feasible, safe, and effective in treatment of SAP.