急性坏死性胰腺炎的营养支持

NUTRITIONAL SUPPORT IN PATIENTS WITH ACUTE NECROTIZING PANCREATITS

自1985年1月～1992年9月,我们对57例急性坏死性胰腺炎病人的营养支持治疗分三期进行,即术后早期经周围静脉输注高渗糖、脂肪乳剂和氨基酸等营养液行全胃肠外营养(TPN);术后2周左右由TPN逐步过渡到全胃肠内营养(TEN),从空肠造瘘内注入要素饮食;最后逐渐过渡为口服饮食。结果除9例病人在TPN治疗期间死于MOF外,余48例病人的营养状况均有不同程度的改善,并均痊愈出院。实践证明营养支持在急性坏死性胰腺炎的治疗中有着良好效果,是提高治愈率的重要措施。

From January 1985 to September 1992, nutritional support in 57 patients with acute necrotizing pancreatitis was divided into three stages: total parenteral nutritional (TPN) was started in the early stages of postoperation, and their nutritional solution which was composed of hypertonic glucose, intralipid and amino acids was given by peripheral intravenous infusion; then total enteral nutrition(TEN), instead of total parenteral nutrition (TPN) was gradually utilized two weeks or so after operation, elemental diets were given by jejunostomy; Oral diets were gradually given in the final stage. With the exception of nine patients who died from multiple organ failure (MOF) during institution of TPN, all the other cases were cured and had various degrees of improvement of nutritional status. The results indicate that nutritional support has a good effect on the patients with acute necrotizing pancrcatitis and is an important measure to improve the cure rate.