不同时机肠内营养对重症急性胰腺炎治疗效果分析

Effect of Different Time Enteral Nutrition on Severe Acute Pancreatitis

【目的】比较不同时机启动肠内营养对重症急性胰腺炎(SAP)治疗效果的影响。【方法】选取本院收治的103例SAP的患者,根据随机数表法将其分为早期肠内营养组(EEN组,n=53)和延迟肠内营养组(DEN组,n=50)。EEN组入院48 h启动肠内营养,DEN组入院96 h启动肠内营养。比较EEN组、DEN组患者住院时间、腹痛明显缓解时间及开始自主排便时间、病死率及并发症等情况,比较两组d14外周血检测营养指标(白蛋白,前白蛋白)及炎症指标(C反应蛋白、降钙素原)的变化。【结果】EEN组腹痛明显缓解时间、开始自主排便时间及住院期间病死率均低于DEN组,差异有统计学意义(P<0.05)。EEN组全身炎症反应综合征(SIRS)、腹腔内高压及胰腺脓肿并发症发生率低于DEN组,差异有统计学意义(P<0.05)。入院10 d后,EEN组外周血白蛋白、前白蛋白水平均低于DEN组,差异有统计学意义(P<0.05);两组组外周血炎症指标(C反应蛋白、降钙素原)比较,差异无统计学意义(P>0.05)。【结论】早期肠内营养支持有利于SAP患者恢复,可减少患者病死率及部分并发症状的发生。

【Objective】To compare the effect of enteral nutrition at different time on severe acute pancreatitis(SAP).【Methods】One hundred and three patients with SAP in our hospital were randomly divided into early enteral nutrition group(EEN group,n=53)and delayed enteral nutrition group(DEN group,n=50).Enteral nutrition was started at 48 hours in the EEN group and 96 hours in the DEN group.The hospitalization time,abdominal pain relief time and spontaneous defecation time,mortality and complications of the EEN group and the DEN group were compared.The changes of nutritional indexes(albumin,prealbumin)and inflammatory indexes(C-reactive protein and procalcitonin)in peripheral blood of the two groups on the day 14th were compared.【Results】The time of abdominal pain relief,the time of spontaneous defecation and the mortality rate during hospitalization in the EEN group were lower than those in the DEN group(P<0.05).The incidence of systemic inflammatory response syndrome(SIRS),intra-abdominal hypertension and pancreatic abscess complications in the EEN group was lower than that in the DEN group(P<0.05).Ten days after admission,the levels of albumin and prealbumin in the EEN group were lower than those in the DEN group,the difference was statistically significant(P<0.05);there was no significant difference in peripheral blood inflammatory indexes(C-reactive protein,procalcitonin)between the two groups(P>0.05).【Conclusion】Early enteral nutrition support is conducive to the recovery of SAP patients,and can reduce the mortality and some complications.