经鼻空肠肠内营养支撑对重症急性胰腺炎肠源性感染患者的临床研究

Clinical study of enteral nutrition support in patients with severe acute pancreatitis

目的探讨经鼻空肠肠内营养支撑对重症急性胰腺炎肠源性感染患者的临床应用效果及价值。方法将我院2013年3月~2015年3月收治的重症急性胰腺炎肠源性感染患者110例作为实验研究对象,采用随机法分成观察组与对照组,各55例,对照组采用肠外营养治疗,观察组采用经鼻空肠肠内营养治疗,比较分析两组患者临床治疗效果、并发症出现几率及肠源性感染指标变化情况。结果观察组患者临床治疗总有效率为94.55%(52/55),对照组治疗总有效率是90.91%(50/55),两组相比无显著差异,P>0.05;两组患者都没有出血消化道穿孔、胰周脓肿等并发症,对照组患者有2例出现腹胀、5例出现腹泻,观察组腹胀、腹泻各出现1例,并发症发生几率无明显差异,P>0.05;观察组患者肠源性感染指标中的白细胞、C反应蛋白都显著低于对照组,P<0.05。结论经鼻空肠肠内营养支撑能显著降低重症急性胰腺炎肠源性感染发生几率,改善其生活质量,值得使用与推广。

Objective To investigate the clinical effect and value of nasal jejunal enteral nutrition support in patients with severe acute pancreatitis. Methods In our hospital from March 2013 to March 2015 from the intestinal infection in severe acute pancreatitis patients 110 cases as study object, divided into observation group and control group randomly, each of 55 cases, control group with parenteral nutrition ther- apy, the treatment group were treated by enteral nutrition, a comparative analysis of two groups of patients with clinical curative effect the probability of complications, and intestinal infection were observed. Results Clinical observation of patients with a total effective rate of 94.55% （52/55） , the control group total effective rate was 90.91% （50/55） , the two groups showed no significant difference, P〉0.05; two groups of patients have no hemorrhage of digestive tract perfo- ration, pancreatic abscess and other complications, patients in the control group there were 2 cases with abdominal disten- sion, 5 cases diarrhea, abdominal distension in the observa- tion group, the diarrhea occurred in 1 cases, the incidence of complications had no significant difference in P〉0.05 ; the patients in the observation group were enterogenous infec- tion index in white blood cells （WBC） , C protein （CRP） were significantly lower than the control group, P〈0.05. Conclusion The results showed that the enteral nutrition support could significantly reduce the incidence of intestinal infection and improve the quality of life in patients with severe acute pancreatitis.