早期肠内营养在重症急性胰腺炎患者中的疗效观察

Effect observation of early enteral nutrition in patients with severe acute pancreatitis

目的观察早期经鼻空肠管肠内营养支持在重症急性胰腺炎(SAP)患者治疗中的应用效果。方法将54例SAP患者随机分成对照组和试验组各27例,所有患者均予抗感染、抑制胰液分泌、抑酸、补液等常规治疗,试验组于发病后72h放置鼻空肠管并给予肠内营养(EN),比较2组患者平均住院日、住院费用、腹痛缓解时间、血淀粉酶恢复时间、并发症发生率,检测2组治疗前、治疗2周后白蛋白(ALB)、前白蛋白(PA)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)水平。结果对照组1例患者因多脏器功能衰竭死亡,试验组患者治疗后顺利出院,与对照组相比,试验组患者在平均住院日、住院费用、腹痛缓解时间、血淀粉酶恢复时间、并发症发生率均明显优于对照组,差异有统计学意义,治疗2周后检测试验组患者白蛋白、前白蛋白水平均高于对照组,差异有统计学意义(P<0.05),2组患者治疗后AST、LDH水平均降至正常,差异无统计学意义(P>0.05);结论在SAP患者中早期实行肠内营养是简单有效的,在促进患者康复过程中发挥重要作用。

Objective To observe the effect of early enteral nutrition （EN） by nasojejunal tube in patinets with severe acute pancreatitis （SAP）. Methods 54 cases of SAP patients were randomly divided into control group and experimental group, each of 27 cases. All patients were treated with anti-infection, inhibition of pancreatic secretion, acid suppression, rehydration and other conventional treatment. The patients in experimental group were placed nasojejunal tube and given enteral nutrition 72 hours after attack, compared the average hospitalization days, cost of hospitalization, abdominal pain relief time, amylase recovery time, complication rates in two groups, detected the level of albumin （ALB） , pre-albumin （ PA）, aspartate aminotransferase （AST） , lactatede-hydrogenase （LDH） in two groups before and two weeks after treatment. Results One patient died of multiple organ failure in control group, patients in experimental group all left hospital. Compared to control group, the average hospitalization days, cost of hospitalization, abdominal pain relief time, amylase recovery time, complication rates in experimental group were better than control group, the difference was statistically significant;the albumin, pre-albumin levels in experimental group were higher than that of control group after two weeks treatment, the difference was statistically significant （ P 〈 0.05 ）. The AST, LDH levels decreased to normal after treatment in two groups, but there was no significant difference in 2 groups （P 〉 0.05） . Conclusion The early enteral nutrition in SAP patients is simple and effective, which plays an important role in promoting the rehabilitation of patients.