肠内营养支持在急性重症胰腺炎治疗中的应用

Application of enteral nutrition support in the treatment of acute severe pancreatitis

目的:探讨急性重症胰腺炎(ASP)肠内营养支持治疗的应用原则、方法及效果。方法:对21例经肠内营养支持治疗的ASP患者的资料进行回顾性总结。结果:治愈17例,加重3例(转上级医院),死亡1例。多数患者在应用肠内营养达2周时,其血清蛋白、体重增加,呈正氮平衡,血清转氨酶、胆红素下降,肝功能明显改善。结论:ASP初期应以肠外营养支持为主,ASP 1周左右是应用肠内营养的较好时机,应用肠内营养时,口服途径应视为禁忌,24 h经鼻肠营养管持续匀速滴入营养物质为首选方法。

Objective:To investigate the application of enteral nutrition support in the treatment of acute severe pancreatitis.Methods:Clinical data of 21 patients with ASP treated with enteral nutrition were reviewed retrospectively.Results:17 caseswere cured;3 cases were aggravated and went to a higher level of hospital;1 case was death.In the majority of patients with ENfor 2 weeks,the serum protein,weight gain,positive nitrogen balance,serum aminotransferase,bilirubin decreased,liver functionimproved significantly.Conclusion:PN should be the main support in the initial stage of ASP,1 week of ASP is a good timeto use EN,w.When using EN,the oral route should be considered as taboo,24 h continuous uniform dripping into the nutrientsubstance through the nasal feeding tube is the first choice