营养方式对重症急性胰腺炎预后的影响

Effects of Different Nutrition Support Methods on Prognosis of Patients with Severe Acute Pancreatitis

目的探讨营养方式的选择对重症急性胰腺炎(SAP)预后的影响。方法选择接受营养治疗的SAP患者154例,其中78例接受全肠外营养(TPN);76例同时接受肠外营养(PN)和肠内营养(EN)。比较两组患者感染率、并发症发生率、住院时间和死亡率的差异。结果与TPN组相比,PN+EN组患者的胰腺感染率PN+EN 7.8%,TPN12.8%,P<0.05,其他部位感染率PN+EN17.1%,TPN24.3%,P<0.05,并发症发生率(PN+EN 31.5%,TPN 38.4%,P<0.05)明显降低,住院时间[PN+EN(36.87±8.93)d,TPN(48.17±14.5)d]明显缩短,死亡率(11.8%,TPN 10.2%,P>0.05)两组无差异。结论PN和EN联合应用是SAP首选的营养方式。

Objective To investigate the effects of different nutrition support methods on prognosis of patients with severe acute pancreatitis(SAP).Methods 154 patients with SAP received stage nutritional support were divided into two groups,78 patients received the total parenteral nutrition(TPN) and 76 patients received combination of parenteral nutrition(PN) and enteral nutrition(EN).The incidence of infections and complications,average hospital stay and the mortality rates were compared between two groups.Results Compared to TPN group,PN+EN group was associated with lower incidences of pancreatic infection,infections in other sites,the complications and average hospital stay,but there was no significant difference about mortalitys.Conclusion PN combined with EN may be the preferred and rational route of nutritional support in patients with SAP.