重症急性胰腺炎早期肠内营养与肠外营养联合的临床疗效分析

Clinical efficacy analysis of early enteral nutrition combined with parenteral nutrition in patients with severe acute pancreatitis

目的:探讨重症胰腺炎患者早期肠内营养与肠外营养联合应用的临床疗效。方法:分析2015年11月~2016年12月接受治疗的重症急性胰腺炎患者106例,将早期接受完全肠内营养营养支持治疗的46例定义为EN组,早期接受肠内营养与肠外营养联合支持治疗的60例定义为PN+EN组。检测营养支持治疗前与营养支持治疗2周后血清白蛋白、血红蛋白、C反应蛋白水平及计算APACHE Ⅱ评分。结果:两组治疗前CRP、ALB、Hb、APACHEⅡ变化均较治疗后明显,差异有统计学意义(P<0.05),且PN+EN组指标变化的幅度较EN组大,临床价值更高(P<0.01)。结论:肠内营养与肠外营养联合支持治疗不仅能维持肠道功能恢复,还可通过下调机体炎症反应,抑制氧化应激反应而发挥全身保护脏器功能作用,改善患者预后。

Objective：To investigate the clinical efficacy of early enteral nutrition combined with parenteral nutrition in patients with severe acute pancreatitis.Methods：106 cases of severe acute pancreatitis treated in department of general surgery in our hospital from November 2015 to December 2016 were retrospectively analyzed,we defineded these 46 patients with early enteral nutrition and nutrition support as EN group,while the other 60 cases by early enteral nutrition combined with parenteral nutrition in the treatment as PN ＋ EN group.Then,before and after nutritional support treatment for 2 weeks,we test the level of Serum albumin,hemoglobin,C reactive protein and calculate APACHE Ⅱ score.Results：The changes of CRP,ALB,Hb and APACHE Ⅱ were significantly higher than those before treatment in the two groups,the difference was statistically significant（P 0.05）,and the change of PN ＋ EN group was larger than that of EN group,the clinical value is higher（P 0.01）.Conclusion：The combination of enteral nutrition and parenteral nutrition can not only maintain the recovery of intestinal function,but also can play an important role in the whole body to protect the organ function,and improve the prognosis of patients by reducing the body＇s inflammatory response and inhibiting oxidative stress.