早期肠内营养治疗重症急性胰腺炎

Early Enteral Nutrition in the Treatment of Severe Acute Pancreatitis

目的:研究早期肠内营养治疗重症急性胰腺炎(SAP)的临床效果。方法:60例SAP患者均分为治疗组和对照组,两组患者入院后均接受相同常规治疗,待胃肠蠕动恢复后,治疗组给予早期肠内营养治疗(EN),对照组给予肠外营养治疗(TPN),疗程14 d;观察两组SAP患者治疗前、治疗14 d后的Ranson评分、APACHEII评分、体重以及白蛋白、血清前白蛋白水平,同时比较两组患者的并发症发生率、死亡率及平均住院时间。结果:治疗组和对照组患者治疗后Ranson评分和APACHEII评分较治疗前均有明显改善(P<0.05),治疗后两组患者Ranson评分和APACHEII评分比较差异无统计学意义(P﹥0.05);两组患者治疗后血清白蛋白和前白蛋白较治疗前均有增加,差异有统计学意义(P<0.05),治疗组血清白蛋白和前白蛋白较对照组改善更明显(P<0.05);对照组患者并发症发生率、死亡率以及平均住院时间大于治疗组,差异具有统计学意义(P<0.05)。结论:SAP患者实施早期EN有助于改善临床症状以及营养状态,降低治疗过程中并发症发生率和死亡率,缩短平均住院时间。

Objective ： To study the clinical effect of early enteral nutrition （EN） in the treatment of severe acute pancreatitis （SAP）. Methods： Sixty patients with SAP were divided into treatment group and control group. Patients in the two groups were given the same routine therapy after admission. Af- ter gastrointestinal motility recovery, treatment group was treated with EN for 14 d, and control group was given parenteral nutrition （TPN） treatment for 14 d. Ranson scores and APACHEII scores, body weight and albumin levels, serum albumin levels were observed before and after treatment. Complica- tion incidences, mortality and the average length of hospital stay were compared between the two groups. Results： Ranson scores and APACHEII scores in the two groups after treatment were obviously improved （ P 〈 0.05 ）. No significant difference was found in Ranson scores and APACHEII scores be- tween the two groups after treatment. Serum albumin and prealbumin levels after treatment were re- markably increased （P 〈 0.05 ）, the changes in treatment group were more significant than those in control group （P 〈 0.05 ）. Complication incidences and mortality in control group were higher and the average hospitalization time was longer than those in treatment group （P 〈 0.05 ）. Conclusions： Early EN can help to improve the clinical symptoms and nutritional status of patients with SAP, decrease in- cidence of complications and mortality, and shorten the average length of hospital stay.