重症急性胰腺炎不同营养支持方式的护理和效果

目的 :比较肠外营养和经鼻-空肠管途径肠内营养在治疗重症急性胰腺炎病人中的应用效果,总结护理方法。方法 :将收治的85例重症急性胰腺炎病人按入院先后分为试验组和对照组。对照组病人给予常规肠外营养支持治疗及相应理,试验组病人则采用鼻-空肠管行肠内营养支持治疗,并在治疗期间给予相应的临床护理干预,就两组病人的各项临床指标进行比较分析。结果 :两组病人护理干预前的血清CRP、ALB、TP水平比较无统计学差异(P0.05);营养治疗及护理干预后,两组病人的CRP、ALB、TP水平均有改善,但试验组改善幅度明显大于对照组,组间差异有统计学意义(P0.05)。试验组病人治疗后BMI指数于对照组未见明显差异(P0.05)。同时其首次下床时间、机械通气时间、腹胀缓解时间、血淀粉酶以及尿淀粉酶恢复时间均较对照组有明显降低(P0.05)。两组病人腹胀、腹泻、恶心呕吐、上消化道出血等并发症比较,试验组均明显低于对照组(P0.05)。结论 :经鼻-空肠肠内营养支持治疗在有效纠正重症急性胰腺炎营养不良的同时,还能够对胃肠道起到保护作用,降低并发症的发生率。良好的临床护理干预能够保证肠内营养的顺利实施。

The analysis of differet nutrition support treatment and nursing in patients with severe acute pancreatitis

Objective:To explore the effect and nursing measures of parenteral nutrition support treatment and nasal jejunum nutrition support treatment in patients with acute severe pancreatitis.Method:85 cases of acute severe pancreatitis were divided into the study group and the control group.The patients in the control group were given routine parenteral nutrition support therapy and clinical nursing.The patients in the study group were treated with nasal jejunum tube for enteral nutrition support,and the corresponding clinical nursing intervention was given during the treatment.The clinical indexes of two groups were compared and analyzed.Result:Before treatment,there were no significant difference in serum CRP,ALB,TP levels between the two groups (P ＞ 0.05).After nutritional treatment and clinical nursing,the above indexes of the two groups were improved,but the indexes of the study group improved significantly more than the control group (P ＜ 0.05).The BMI index in the study group was not significantly different compared with the control group (P ＞ 0.05).In the study group,the first time of get out of bed,mechanical ventilation time,abdominal distension remission time,sserum amylase and urine amylase recovery time were significantly lower than those of the control group (P ＜ 0.05).The incidence of complications including abdominal distension,diarrhea,nausea and vomiting,upper gastrointestinal bleeding in the study group were significantly lower than those in the control group (P ＜ 0.05).Conclusion:nasal jejunum nutrition support treatment can not only play a vital role in treatment of acute severe pancreatitis patients with malnutrition,but also protect the patient gastrointestinal tract.The individualized nursing intervention can effectively reduce the incidence of complications and ensure the successful implementation of enteral nutrition.