鼻胃镜介导安置鼻空肠营养管治疗重症急性胰腺炎疗效分析

Effect of enteral nutrition by transnasal gastroscope placement of nasal jejunum nutrition tube in the treatment of severe acute pancreatitis

目的探讨鼻胃镜介导安置鼻空肠营养管行肠内营养(EN)治疗对重症急性胰腺炎(SAP)的疗效。方法回顾性分析自2015年7月至2017年7月沈阳军区总医院收治的65例SAP患者的临床资料。根据具体操作实施方法将患者分为鼻胃镜介导组(n=25)、常规安置组(n=21)和未安置组(n=19)。比较鼻胃镜介导组和常规安置组操作时间、操作过程中反应及时长、置管成功率;比较3组重症监护时间、治愈好转率等指标。结果鼻胃镜介导组患者实施操作时间为入院后(6.25±2.40)d,常规安置组为入院后(7.16±2.80)d,两组比较,差异无统计学意义(P>0.05)。鼻胃镜介导组置管操作时间为(8.5±4.2)min,显著长于常规安置组的(5.6±3.2)min,两组比较,差异有统计学意义(P<0.05)。鼻胃镜介导组操作过程不适反应较强烈,常规安置组操作过程尚可耐受。鼻胃镜介导组置管成功率达100.0%(25/25),显著高于常规安置组的76.2%(16/21),两组比较,差异有统计学意义(P<0.05)。与未安置组比较,鼻胃镜介导组、常规安置组患者重症监护时间短、治愈好转率高。结论鼻胃镜介导置入鼻空肠营养管虽较常规操作法操作时间长、不适感明显,但成功率高,对EN的实施及治疗效果有利。

Objective To investigate the effect of enteral nutrition by transnasal gastroscope placement of nasal jejunum nutrition tube in the treatment of severe acute pancreatitis(SAP).Methods A retrospective study was performed on 65 cases of SAP patients who were admitted from July 2015 to July 2017.According to the different placement methods,patients were divided into the nasal gastroscopy group(n=25),routine placement group(n=21)and non-placement group(n=19).The operative time,the reaction time during operation and success rate were compared between the nasal gastroscopy group and the routine placement group;the intensive care time,cured and improved rate were analyzed among the three groups.Results There was no significant difference of the operative time after admission between the nasal endoscopy group(6.25±2.40)days and routine placement group(7.16±2.80)days(P>0.05).The operation time of the nasal endoscopy group was(8.5±4.2)minutes,which was significantly longer than(5.6±3.2)minutes of the routine placement group(P<0.05).The feeling of the patients in the nasal endoscopy group during the operative process was discomfort,and which of the routine placement group was tolerable.The success rate of the nasal endoscopy group was 100.0%(25/25),which was significantly higher than 76.2%(16/21)of the routine placement group(P<0.05).Compared with the non-placement group,the intensive care time was shorter,cured and improved rate was higher in the nasal gastroscopy group and the routine placement group.Conclusion To SAP patients,although the operation time is longer,the discomfort is more obvious during nasal jejunum nutrition tube placement by transnasal gastroscope than routine placement,the success rate is higher,and it is beneficial to the enteral nutrition and treatment effect.