大肠水疗联合早期肠内营养在治疗重症胰腺炎中的作用

Analysis of curative effect of early colorectal therapy combined with early enteral nutrition in the treatment of severe

[目的]分析大肠水疗联合早期肠内营养(enteral nutrition,EN)对重症急性胰腺炎(severe acute pancreatitis,SAP)治疗的效果。[方法]将80例SAP患者按随机原则分为常规治疗组(38例)和大肠水疗联合EN组(42例),常规治疗组接受常规治疗;大肠水疗联合EN组在常规治疗的基础上采用大肠水疗联合EN进行治疗。观察2组患者治疗后症状改善时间、肠道功能恢复情况、住院时间、血清C-反应蛋白(CRP)、乳酸脱氢酶(LDH)、淀粉酶(AMY)及并发症、胰周感染率。[结果]大肠水疗联合EN组腹部压痛、腹胀、腹痛消失及恢复排气时间均较常规治疗组明显缩短(均P<0.05),胰周感染率低于常规治疗组(P<0.05);2组治疗后血清CRP、LDH、AMY水平均较治疗前降低,并随治疗时间延长降幅不断增加,大肠水疗联合EN组降幅更大。[结论]采用大肠水疗联合EN治疗SAP,可以增强对SAP的治疗效果,减少SAP患者并发症、住院时间和病死率,有利于SAP患者尽快康复。

[Objective]To evaluate the effect of enteral nutrition（EN）on the treatment of severe acute pancreatitis（SAP）.[Methods]Eithty patients with SAP were randomly divided into routine treatment group and treatment group.The routine treatment group（38 cases）received routine treatment.The treatment group（42 cases）was additionally treated with rectal hydrotherapy combined with EN.The time of symptom improvement,the recovery of intestinal function,the time of hospitalization,serum C-reactive protein（CRP）,amylase（AMY）and complication and peripancreatic infection were observed.[Results]Abdominal tenderness,abdominal distention,abdominal pain disappeared,and exhaustion time of recovery were significantly shorter in the large intestine hydrotherapy combined EN group than in the conventional treatment group（all P〈0.05）,and the peripancreatic infection rate was lower than that in the conventional treatment group（P〈0.05）.After treatment,serum CRP,LDH,and AMY levels were lower than those before treatment,and decreased gradually with the extension of treatment time.Larger hydrotherapy combined with EN group had a greater reduction.[Conclusion]The treatment of SAP with colorectal hydrotherapy combined with EN can improve the therapeutic effect on SAP,reduce the complication and hospitalization time of SAP patients,and reduce the complication and mortality.It is helpful for SAP patients to recover as soon as possible.