早期行肠内营养在重症胰腺炎治疗中的作用

Study of early enteral nutrition therapy in patients with acute severe pancreatitis

目的探讨早期行肠内营养在重症胰腺炎治疗中的作用。方法收集2013年1月-2015年2月在南京军区南京总医院急救医学科收治的58例重症胰腺炎患者病例资料,按照随机数字表法随机分成采用早期肠内营养治疗组(观察组)和采用常规治疗组(对照组)各29例。比较两组患者治疗前和治疗后3周时的APACHEⅡ评分、前清蛋白与血清清蛋白的差异。结果两组患者治疗前APACHEⅡ评分均值差异无统计学意义(P>0.05),观察组重症胰腺炎患者治疗后3周时APACHEⅡ评分结果明显低于对照组[(1.7±0.4)分vs.(3.0±0.9)分](P<0.05);观察组治疗后3周时前清蛋白含量均值为(263.5±11.4)mg/L,明显高于对照组患者含量水平(200.9±15.8)mg/L(P<0.05),与此同时,两组重症胰腺炎患者治疗后3周时血清清蛋白含量水平差异具有统计学意义[(34.1±2.5)g/L vs.(31.5±3.0)g/L](P<0.05)。结论早期行肠内营养对于改善重症胰腺炎患者的病情具有重要的临床意义。

Objective To investigate the effect of early enteral nutrition therapy in acute severe pancreatitis patients. Methods Data of acute severe pancreatitis patients treated in Emergency Medicine Department of Nanjing General Hospital of Nanjing Military Command from January 2013 to February 2015 were collected. A total of 58 cases were randomly divided into the early enteral nutrition in treatment group （ observation group） and the conventional treatment group （ control group） according to randomized digital table. The APACHEⅡ scores, serum albumin and prealbumin between before and after treatment for 3 weeks of two groups of patients were compared. Results There was no significant difference on APACHEⅡ scoring average between the two groups before treatment （P〉0.05）. APACHEⅡ scores of the observation group three weeks after treatment were obviously lower than the control group [（1.7± 0.4） vs. （3.0±0.9）] （P〈0.05）; The average of prealbumin in the observation group was（263.5±11.4）mg/L, and the values was significantly higher than those in the control group（200.9±15.8）mg/L. Meanwhile, three weeks after treatment, albumin of the two groups was statistically significant [（34.1±2.5）g/L vs. （31.5±3.0）g/L] （P〈0.05）. Conclusion Early enteral nutrition is important for improving the condition of patients with severe pancreatitis.