急性重症胰腺炎阶段性营养支持治疗的临床观察

Clinical observation of staged nutrition support in patients with severe acute pancreatitis

目的观察阶段性营养支持治疗对急性重症胰腺炎(SAP)预后的影响。方法选择SAP患者46例随机均分成两组分别接受全肠外营养(TPN),肠外营养(PN)加肠内营养(EN)。观察两组在血清学指标、并发症、继发感染、死亡率、住院时间和住院费用的差异。结果PN加EN组全部患者均能耐受早期肠内营养;两组患者在给予营养后总蛋白、清蛋白、血钙水平与营养支持前相比均明显升高,差异有统计学意义(P<0.05);营养支持后两组间在总蛋白、清蛋白、血钙水平差异有统计学意义(P<0.05);在继发感染、并发症、住院时间和费用上PN加EN组均少于TPN组,差异有统计学意义(P<0.05)。结论SAP患者早期进行肠内营养是可靠、有效、可行的,并可作为营养支持治疗的首选。

Objective To observe the therapeutic effect of staged enteral and parenteral nutrition support in the patients with se- vere acute pancreatitis. Methods 46 patients were randomized into 2 groups as follows：TPN,PN＋ EN. Differences between TPN and EN＋PN were observed in complication, secondary infection,mortality,and other indexes. Results All of 23 patients in the group of PN＋ EN could tolerate the therapy of enteral nutrition; the group of PN ＋ EN was less than group TPN in complication, secondary infection, mortality, hospitalization, and hospitalization costs（P〈0.05）; the group TPN was more than group TPN in the level of total protein,albumin,and blood caleium（P〈0.05）. Conclusion It is reliable,effective,and feasible for severe acute pancre- atitis to administrate enteral nutrition early,enteral nutrition is first choice for SAP.