肠内营养在重症急性胰腺炎治疗中的应用

The Role of Enteral Nutrition Support in Treatment of Acute Severe Pancreatitis

目的探讨肠内营养在重症急性胰腺炎(SAP)治疗中的应用价值。方法分析30例SAP患者的临床资料,按营养支持不同分为肠内营养(EN)16例和全胃肠外营养(TPN)14例。观察两组治疗结果及临床指标的变化。结果营养支持2周后,两组患者的APACHEⅡ评分、CTSI较前显著降低,且EN组的各项评分均显著低于TPN组,差异均有高度统计学意义(均P<0.01)。营养支持后两组的血糖、血清白蛋白、血钙和血肌酐均较前有显著改善,差异有高度统计学意义(P<0.01),但两组之间各项指标的差异无统计学意义(P>0.05)。同时,EN组平均住院天数明显缩短,中转手术率、感染率、病死率方面EN组均明显低于TPN组,差异均有统计学意义(均P<0.05)。结论EN治疗SAP疗效优于TPN,应用于临床是安全可行的。

Objective To investigate the role of enteral nutrition support in treatment of acute severe pancreatitis. Methods The data on 30 patients with SAP were retrospectively analyzed. They were randomly assigned to receive either enteral nutrition （EN group,n=16）or total parenteral nutrition （TPN group, n=14）. The changes of clinical indicators and clinical outcome were recorded. Results Two weeks after nutritional support, the APACHE Ⅱscore and CTSI score were significantly lower in the ENgroup than in the TPN group（P〈0.01）. The blood glucose,serum albumin , the blood calcium and serum creatinine in both groups were notably improved （P〈0.01）,however,no significant difference was found between these two groups（P〉0.05）. The average hospital stay was also notably shortened in the EN group. The incidence of shift to operation, complications and mortality were significantly lower in the EN group than in the TPN group （P〈0.05）. Conclusion Enteral nutrition is safe and effective in the treatment of SAP.