早期腹腔引流联合早期肠内营养在重症急性胰腺炎中的应用价值

Application Value of Early Abdominal Drainage Combined with Early Enteral Nutrition in Severe Acute Pancreatitis

目的探讨早期腹腔置管引流联合早期肠内营养(EN)在重症急性胰腺炎(SAP)患者中的应用价值。方法选择2020年7月至2021年7月于南阳市第一人民医院就诊的84例SAP患者为研究对象,依据随机数表法将入选患者分为观察组及对照组,每组42例。两组患者均接受常规治疗,对照组在此基础上接受早期腹腔引流治疗,观察组在对照组基础上接受EN治疗。比较两组患者的总有效率、营养指标、炎症指标以及预后。结果观察组总有效率(95.24%)高于对照组(80.95%),差异有统计学意义(P<0.05)。治疗后,两组患者白蛋白(ALB)、前白蛋白(PA)水平呈升高趋势,观察组上述指标水平高于对照组(P<0.05)。治疗后,两组患者C反应蛋白(CRP)、白细胞介素-10(IL-10)水平呈降低趋势,观察组上述指标水平低于对照组(P<0.05)。观察组患者腹痛缓解时间、重症监护室(ICU)停留时间、住院时间短于对照组,继发腹腔感染率、死亡率低于对照组(P<0.05)。结论早期腹腔引流联合早期EN可有效提高SAP患者的治疗总有效率,改善患者的营养状况,抑制炎症反应,降低患者的病死率,加快患者康复。

Objective To investigate the application value of early abdominal drainage combined with early enteral nutrition(EN)in patients with severe acute pancreatitis(SAP).Methods A total of 84 SAP patients who were treated in the First People’s Hospital of Nanyang from July 2020 to July 2021 were selected as the research objects.According to the random number table method,the selected patients were divided into an observation group and a control group,with 42 cases in each group.Both groups of patients received conventional treatment,the control group received early abdominal drainage therapy on this basis,and the observation group received EN therapy on the basis of the control group.The total effctive rate,nutritional indicators,inflammatory indicators and prognosis of the two groups of patients were compared.Results The total effective rate of the observation group(95.24%)was higher than that of the control group(80.95%)(P<0.05).After treatment,the levels of albumin(ALB)and prealbumin(PA)in the two groups increased,and the levels of the above indexes in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of C-reactive protein(CRP)and interleukin-10(IL-10)in the two groups decreased,and the levels of the above indexes in the observation group were lower than those in the control group(P<0.05).Abdominal pain relief time,intensive care unit(ICU)stay time,and hospitalization time in the observation group were shorter than those in the control group,and the secondary abdominal infection rate and mortality were lower than those in the control group(P<0.05).Conclusion Early abdominal drainage combined with early EN can effectively improve the overall treatment efficiency of SAP patients,improve the nutritional status of patients,inhibit inflammatory response,reduce the mortality of patients,and speed up the recovery of patients.