早期应用留置胃管持续负压盘吸引联合鼻空肠置管早期肠内营养治疗对重症胰腺炎预后的影响

Effect of Nasogastric Tube Suction combined with Early Nose-jejunal Nutrition Support on Prognosis of Severe Acute Pancreatitis

目的:探讨留置胃管持续负压盘吸引联合鼻空肠置管进行早期肠内营养和肠外营养支持对于重症急性胰腺炎(SAP)预后的影响。方法:将SAP患者随机分为研究组22例和对照组23例,研究组患者自确诊SAP后立即留置胃管持续负压盘吸引联合鼻空肠置管进行早期肠内营养支持治疗,对照组患者均采用单纯胃肠减压和肠外营养支持治疗。比较两组患者危重症评分(APACHEⅡ)情况、血清白蛋白水平、CRP水平、通便时间、腹痛缓解时间、置管时间、肠鸣音恢复时间、血淀粉酶恢复正常时间。结果:两组患者治疗当天APACHEⅡ评分差异无统计学意义(P>0.05)。随着治疗时间的增加两组的APACHEⅡ评分均逐渐下降,研究组治疗后7 d明显低于对照组(P<0.05);研究组治疗后10天血清白蛋白水平明显高于对照组(P<0.05);血CRP水平明显低于对照组(P<0.05);研究组通便时间、置管时间、肠鸣音恢复时间、血淀粉酶恢复正常时间明显短于对照组(P<0.05)。两组患者腹痛缓解时间无统计学意义(P>0.05)。结论:早期留置胃管持续负压盘吸引联合鼻空肠置管早期肠内营养治疗对于SAP患者的治疗较单纯胃肠减压和肠外营养支持效果更佳。

Objective： To explore the effect of nasogastric tube suction combined with early nose-jejunal nutrition support on prognosis of severe acute pancreatitis （SAP）. Methods： Patients with SAP were randomly divided into intervention group （n = 22 ） and control group （n = 23）. The intervention group was given nasogastric tube suction and nose-jejunal nutrition support treatment as soon as the diagnosis of SAP was established, while the control group was given only nasogastric tube suction and parenteral nutrition support treatment. The APACHE I/ score, level of serum albumin, CRP, defecation time, abdominal pain disappear time, tube reservation time, borborygmus recover time, and hemodiastase normal time of two groups were compared. Results： There was no significant difference in the APACHE 1I score between two groups before treatment. The APACHE 11 score of the two groups decreased gradually with the increasing of treatment days. Seven days after treatment, the APACHE II score in intervention group were lower than that in control group （P 〈 0.05） ; the level of serum albumin 10 days after treatment in intervention group were greater than that in control group （P 〈 0.05 ）; the level of serum CRP 10 days after treatment in intervention group were lower than that in control group （P 〈 0.05）; defecation time, tube reservation time, borborygmus recover time, hemodiastase normal time in intervention group were shorter than those in control group （P 〈 0.05）. There was no significant difference in the abdominal pain disappear time between the two groups. Conclusion： The nasogastric tube suction combined with early nose-jejunal nutrition support in treatment of SAP is superior to nasogastric tube suction with parenteral nutrition support.