早期肠内营养在重症急性胰腺炎中的应 用

目的 观察重症急性胰腺炎（SAP）患者早期肠内营养（EN）治疗的疗效.方法 将45例SAP患者随机分成EN组（22例）和TPN组（全胃肠外营养,23例）.EN组患者采取早期EN＋TPN治疗,并逐渐减少PN的用量,直至停止TPN; TPN组患者采取TPN治疗.观察2组患者全身炎性介质反应指标、APACHEⅡ评分、营养指标的变化,感染率、病死率、住院时间及住院费用等.结果 2组患者通过营养支持后,血清白蛋白、前白蛋白、转铁蛋白均逐渐上升,治疗后10d上升幅度2组比较差异均无统计学意义（均P＞0.05）,治疗第14天EN组的上升幅度较TPN组明显升高（P＜0.05）.2组患者治疗后体质量比较差异无统计学意义（P＞0.05）.EN组CRP、白细胞计数、APACHEⅡ评分、腹胀缓解时间、住院时间、住院费用、感染及病死率均低于TPN组,血小板计数高于TPN组（均P＜0.05）.结论 早期EN治疗可显著提高SAP患者的治愈率,降低感染率及并发症的发生,并缩短住院时间.

Early Enteral Nutrition Support for Severe Acute Pancreatitis

Objective To observe the curative effect of early enteral nutrition support on severe acute pancreatitis （SAP）. Methods Forty-five SAP patients were randomly divided into two groups. Patients in EN group（n=22）were given early enteral nutrition and total parenteral nutrition（the doses of parenteral nutrition were gradually reduced to zero）. Patients in TPN group （n=23） only received total parenteral nutrition. Systemic inflammatory response indexes, APACHE Ⅱ scores, nutrition indicators, infection rate, mortality, hospital stay and hospital costs were recorded in both groups. Results Serum albumin, prealbumin and transferring levels obviously increased after nutrition support. There were no significant differences in the increased values between the two groups 10 days after treatment （P〉0.05）, but the increased values in EN group were significantly greater than those in TPN group on the 14 th day（P〈0.05）.No obvious differences in the body mass were found between the two groups after treatm- ent （P〉O.05）.Compared with TPN group, cAMP receptor protein, white blood cell count, APACHE Ⅱ scores, Abdominal distension relief time, hospital stay, hospital costs, infection rate and mortality decreased, but blood platelet count increased in EN group （all P〈0.05）. Conclusion Early enteral nutrition support can improve cure rates, reduce infections, decrease complications and shorten hospital stay in patients with SAP.