基于肠内营养耐受性定时评估管理的营养支持对急性重症胰腺炎的临床疗效及预后观察

Clinical Efficacy and Prognosis of Nutritional Support for Acute Severe Pancreatitis Based on Regular Assessment of Enteral Nutritional Tolerance

目的探究急性重症胰腺炎给予基于肠内营养耐受性定时评估管理的营养支持的临床疗效。方法收集78例在本院2016年1月1日至2019年12月31日收治确诊的急性重症胰腺炎患者,不限性别,年龄在30~60周岁。随机将其分为肠内营养耐受性定时评估管理的营养支持组(管理组)和常规护理干预组(常规组),每组39例。观察两组患者目标营养量达标时间、机械通气时间、ICU停留时间,并对肠内营养前后组间血清营养指标水平变化及肠内营养不耐受症状发生情况进行比较。结果管理组营养量达标时间、机械通气时间以及ICU停留时间明显短于常规组,差异均有统计学意义(P<0.05);管理组血清营养指标总蛋白、白蛋白、前白蛋白及转铁蛋白高于常规组,差异均有统计学意义(P<0.05);管理组早期肠内营养不耐受症状发生率10.26%,明显低于常规组33.33%,差异均有统计学意义(P<0.05)。结论基于早期肠内营养耐受性定时评估管理的肠内营养支持,可有效提高SAP患者营养状况及营养治疗安全性。

Objective To investigate the clinical efficacy of acute severe pancreatitis with nutritional support based on regular assessment of enteral nutritional tolerance.Methods 78 patients with confirmed acute severe pancreatitis were admitted to our hospital on January 1,2016 and December 31,2019,regardless of gender,aged between 30 and 60 years old.They were randomly divided into nutritional support group(management group)and routine nursing intervention group(routine group),with 39 patients in each group.To observe the target nutrient amount reaching the standard time,mechanical ventilation time and ICU stay time of patients in the two groups,and to compare the changes of serum nutrient index level and the occurrence of enteral nutrition intolerance symptoms between groups before and after enteral nutrition.Results Nutrition standard time,mechanical ventilation time and ICU stay time in the management group were significantly shorter than those in the conventional group,and the differences were statistically significant(P<0.05).Total protein,albumin,prealbumin and transferrin in the management group were higher than those in the conventional group,and the differences were statistically significant(P<0.05).The incidence of early enteral nutritional intolerance in the management group was 10.26%significantly lower than that in the conventional group,33.33%,with statistically significant differences(P<0.05).Conclusion Enteral nutrition support based on early enteral nutrition tolerance assessment and management can effectively improve nutritional status and nutritional treatment safety of SAP patients.