早期肠内营养在重症急性胰腺炎治疗中的应用

The application of early enteral nutrional support in the treatment of severe acute pancreatitis

目的观察早期肠内营养在重症急性胰腺炎(SAP)治疗中的临床疗效。方法 56例SAP患者,用随机数字表法分为肠内营养组(EN组,26例)和全胃肠外营养组(TPN组,30例)。结果治疗第14天,EN组CD3^+、CD4^+、CD4^+/CD8^+,Ig G、Ig A、Ig M值以及白蛋白均高于TPN组(P<0.05);EN组IL-8、TNF、腹内压均显著低于TPN组(P<0.01)。EN组感染率、MODS发生率、28 d病死率和ICU住院时间均低于TPN组(P<0.05)。结论早期肠内营养不仅可以调节SAP患者的免疫功能,抑制炎症反应,改善营养状况,而且减少了感染率。MODS发生率、ICU住院时间及28 d病死率。

Objective To observe the effect of early enteral nutrition support in the treatment of patients with severe acute pancreatitis（SAP）. Methods A total of 56 SAP patients were randomly divided into enteral nutrition（EN） group（n=26） and total parenteral nutrition（TPN） group（n=30）. Results At the 14 th day after treatment,the count of CD3＋, CD4＋, CD4＋/CD8＋, IgG, IgA, IgM, albumin in EN group were significantly increased than those in TPN group（P〈0.05）; the count of IL-8, TNF, intra-abdominal pressure in EN group were significantly increased than those in TPN group（P〈0.01）. Infection and MODS incidence, 28-day mortality and the length of ICU stay in EN group were significantly descended than those in TPN group（P〈0.05）.Conclusion Early enteral nutrition can not only adjust the immune function, inhibit inflammatory reaction, improve the nutritional status in patients with SAP, but also can reduce the infection and MODS incidence, 28-day mortality and the time length of ICU stay in SAP patients.