不同营养方式对重症急性胰腺炎患者预后影响

Influence of different nutrition support methods on the prognosis Of patients with severe acute pancreatitis

目的探讨临床上不同的营养方式对重症急性胰腺炎患者预后的影响。方法将确诊为重症急性胰腺炎(SAP)的患者66例随机分为3组:肠内营养组(EN)、肠外营养组(PN)和EN+PN组。分别观察入院时及营养支持治疗3 d、7 d、14 d后的血淀粉酶及乳酸脱氢酶、WBC等生化指标,并比较了3组的并发症发生率、感染率、病死率等。结果给予营养支持后观察发现:PN+EN组在血淀粉酶、乳酸脱氢酶、WBC、并发症发生率、感染率、病死率均较其余两组低(P<0.05);3组间的APACHEⅡ评分、Balthazar CT积分、Binder合并症评分比较差异具有显著性(P<0.05)。结论肠内营养联合全胃肠外营养对于改善重症急性胰腺炎患者的预后具有重要的意义,方法安全、有效,值得在临床推广应用。

Objective To investigate the impact factors on different nutrition support methods on the prognosis of patients with severe acute pancreatic it is.Methods 66 patients with severe acute pancreatic it is divided randomly into three groups： enteral nutrition（EN） group,parenteral nutrition（PN） group and EN ＋ PN group.After nutrition support treatment,levels of hem diastase（AMS） and several immunological indexes WBC in three groups were tested.The incidence of infections and complications,average hospital stay and the mortality rates were compared between two groups.Results Compared to EN groups and PN group,PN ＋ EN group was associated with lower levels of AMS,WBC and lower incidences of pancreatic infection,infections in other sites,mortalities,the complications and average hospital stay（P〈0.05）.The differences in APACHEⅡscores and Balthazar scores among three groups also have statistical significance（P〈0.05）.Conclusion PN combined with EN may be the preferred and rational route of nutritional support in patients with severe acute pancreatitis.