重症急性胰腺炎患者早期肠内营养治疗的作用及价值探讨

Investigation on the Effect and Value of Early Enteral Nutrition on Patients with Severe Acute Pancreatitis

目的:探讨经鼻空肠管早期行肠内营养(EN)在重症急性胰腺炎(S AP)治疗中的作用。方法:40例SAP患者随机分为治疗组和对照组,每组各20例,对照组给予常规治疗,治疗组在常规治疗的基础上加用肠内营养。观察两组治疗前后血清白蛋白和淀粉酶水平、血浆内毒素及肿瘤坏死因子TNF-α水平的变化情况。考察治愈率症、感染率、病死率、平均住院时间及费用。结果:治疗组患者行肠内营养后,血浆内毒素、TNF-α下降速度明显快于对照组P<0.05,感染率、平均住院时间与费用明显降低。结论:EN能改善ASP患者的营养状况,改善肠道黏膜屏障及降低炎性细胞因子分泌来加强治疗效果,是SAP重要治疗手段。

Objective: To investigate the effect of early enteral nutrition via nasogastrojejunal tube in treatment of severe acute pancreatitis(SAP).Methods: 40 patients with SAP randomly divided into treatment group and control group,20 cases in each group.The control group were given general treatment,and the treatment group were given general treatment plus enteral nutrition.The plasma endotoxin,serum albumin and amylase levels and tumor necrosis factor(TNFα) were observed before and after treatment.The cure rate,infection rate,fatality rate,average hospital stays and costs were also observed and analyzed.Results: After treated with enteral nutrition,the plasma endotoxin and TNFα levels of patients in treatment group decreased significantly faster than those in control group(P<0.05).The infection rate,average hospital stays and costs were also induced much.Conclusion: Enteral nutrition therapy can improve the intestinal mucosal barrier and reduce secretion of inflammatory cytokines to enhance the therapeutic effect.So it is important in treating patients with SAP.