重症胰腺炎营养支持治疗的临床研究

Clinical research of nutritional support treating severe acute pancreatitis

目的探讨急性重症胰腺炎(SAP)营养支持治疗策略对其预后的影响。方法回顾性分析重庆医科大学附属第二医院自1998年1月至2009年12月收治的75例SAP患者资料,分为全肠外营养(TPN)组和肠内营养(EN)加肠外营养(PN)组。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。结果两组患者均能耐受早期肠外营养;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);治疗后两组间在总蛋白、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分阶段性营养支持治疗是安全、有效的,EN在SAP治疗中应尽早使用。

Objective To retrospectively analyse the effect of the nutritional support on the prognosis for severe acute pancreatitis.Methods Retrospective analysis in our department since 1998 was performed on 75 cases of severe acute pancreatitis.Differences of between TPN and EN＋PN were observed in application,secondary infection,mortality,and other indexes.Results All of 75 patients in the group PN＋EN tolerated the therapy of enteral nutrition.Group PN ＋ EN was less than group TPN in application,secondary infection,mortality,hospitalization,and hospitalization costs（P〈0.05）.Group TPN was more than group TPN in the level of total protein,albumin,and blood calcium（P〈0.05）.Conclusion Severe acute pancreatitis treated with early enteral nutrition should be preferred.