液囊空肠导管在重症胰腺炎患者肠内营养支持中的应用

Liquid Bag Jejunum Tube in Early Enteral Nutrition Support for Severe Pancreatitis

目的探讨液囊空肠导管在重症胰腺炎患者早期肠内营养支持中的应用价值。方法将64例重症胰腺炎患者分为液囊空肠导管组(研究组)和单纯鼻胃管加鼻肠管组(对照组)各32例。研究组将液囊空肠导管一腔置于空肠20～30cm以下进行肠内营养,一腔置于胃内行胃肠减压;对照组先置鼻胃管行胃肠减压,病情稳定后由另一鼻腔置鼻肠管。比较两组患者的肠内营养开始时间、营养全量达到时间、住院时间、住院费用、导管并发症的发生情况及血浆白蛋白水平。结果研究组患者导管脱出的发生率低于对照组(P<0.01),EN开始时间和到达全量时间均早于对照组(P<0.05或0.01),血浆白蛋白值升高早于对照组(P<0.05),住院天数及费用均少于对照组(P<0.05或0.01)。结论液囊空肠导管的应用使胃肠减压及肠内营养同时进行,提前了肠内营养的开始时间,避免了管道占据患者两侧鼻孔所造成的不适,从而提高了患者对治疗的依从性。

Objective To investigate the application value of liquid bag jejunum tube in early enteral nutrition （EN） support for severe pancreatitis. Methods Sixty-four patients with severe pancreatitis were randomly divided into the experimental group treated with liquid bag jejunum tube and the control group treated with nasogastric/nasojejunal tube with 32 patients in each group. In the experimental group,One end of jejunum tube was placed 20-30 cm below jejunum for EN,and the other end was placed in stomach for gastrointestinal decompression. In the control group,nasogas- tric tube was placed first for gastrointestinal decompression,and then nasojejunal tube was placed by another nasal in stable condition. A comparison was conducted between the starting time of EN, time for total nutrition, hospitalization time, hospitalization costs, catheter complications, and level of plasma album. Results The incidence of catheter complications was significantly lower than that in the control group（P〈0.01）. The starting time of EN and time for total nutrition were significantly earlier in the experimental than those in the control group（P〈0.05 or 0. 01）. The elevation of plasma album level was superior to that in the control group（P〈0.05）. The length of hospitalization time, hospital costs were significantly less in the experimental group than those in the control group（P〈0.05 or 0. 01）. Conclusion Gastrointestinal decompression and EN were carried out simultaneously with the application of the liquid bag jejunum tube. The starting time of EN was shortened and the discomforts caused by the occupation of both sides of nose with the tube were avoided, which improved patients＇ compliance to the treatment.