整蛋白型肠内营养液治疗重症急性胰腺炎的疗效观察

Effect of enteral nutrition by a polymeric formula in patients with severe acute pancreatitis

目的观察整蛋白型肠内营养液治疗重症急性胰腺炎（SAP）的疗效。方法将58例SAP患者按随机数字表法分为整蛋白组（29例）和要素组（29例）。两组患者均按照常规SAP的治疗方案治疗，采用胃镜辅助置入鼻肠管后行肠内营养支持。整蛋白组肠内营养采用整蛋白型制剂，要素组采用要素型制剂。观察两组患者胃肠道耐受性（VAS评分）、腹泻发生率、感染发生率、28d病死率及住院天数，检测入院时和入院1周后的血前白蛋白、白蛋白、ALT、C反应蛋白等水平。结果两组患者VAS评分、腹泻发生率、继发感染率、28d病死率及住院天数的差异均无统计学意义（P值均〉0．05）；入院时和入院后1周的前白蛋白、白蛋白、ALT以及C反应蛋白水平的差异亦均无统计学意义（P值均〉0．05）。结论与要素配方肠内营养液相比，整蛋白型肠内营养液价格适中、配置方便，且具有良好的肠道耐受性，适合在SAP早期肠内营养中使用。

Objective To evaluate the effect of enteral nutrition by a polymeric formula in patients with severe acute pancreatitis （SAP）. Methods Fifty-eight patients with SAP were randomly divided into polymeric group （29 cases） and semi-elemental group （29 cases） , and the two groups of patients were treated in accordance with the conventional SAP management protocol, nasojejunal tube was endoscopically inserted for enteral nutrition. The polymeric group received enteral nutritional suspension （TPF）, and the semi-elemental group received the same quantity of VIVONEX TEN. The gastrointestinal tolerance （VAS score）, incidence of diarrhea, infection, 28 - day mortality rate, and length of hospital stay was evaluated. Nutritional parameters were evaluated by pre-albumin, albumin, alanine aminotransferase, C reactive protein at the time of admission and one week later. Results The two groups of patients were comparable in terms of VAS score, incidence of diarrhea, infection, 28-day mortality rate, and length of hospital stay （P 〉 0.05 ）. And the levels of prealbumin, albumin, alanine aminotransferase, C reactive protein after admission were not statistically significant （ P 〉 0.05 ）. Conclusions Compared with the semi-element formtda, the price of polymeric formula is cheap, configuration is convenint, enteral nutrition is well tolerated, and it is suitable for early enteral nutrition in SAP.