重症急性胰腺炎的早期营养支持治疗

目的分析重症急性胰腺炎的早期营养支持治疗方法及效果。 方法选取了2013年10月至2016年10月收治的122例重症急性胰腺炎患者作为研究对象，随机分为肠内营养组(EN组)和肠外营养组(TPN组)，使用SPSS19.0统计软件进行分析，两组患者的并发症发生率采用χ²检验；各项营养指标、APACHEⅡ评分和Ranson评分采用( ±s)表示，独立t检验。P<0.05差异具有统计学意义。 结果两组患者治疗前的营养指标以及APACHEⅡ评分和Ranson评分相比差异无统计学意义(P>0.05)，治疗后，肠内营养组患者的各项营养指标均明显优于肠外营养组(P<0.05)，且肠内营养组患者的APACHEⅡ评分和Ranson评分明显低于肠外营养组(P<0.05)；肠内营养组患者的肾衰、腹腔感染等并发症发生率明显低于肠外营养组(P<0.05)。 结论应用早期肠内营养治疗可以有效改善重症急性胰腺炎患者的身体营养状况，从而提高患者的免疫力，降低了患者的APACHEⅡ、Ranson评分以及并发症发生率，宜广泛应用于临床治疗中。

Study on the Methods and Effects of Early Nutritional Support in the Treatment of Severe Acute pancreatitis

ObjectiveTo analyze the method and effect of early nutritional support in the treatment of severe acute pancreatitis. MethodFrom October 2013 October 2016, 122 cases of severe acute pancreatitis treated in our hospital were selected prospectively. All patients were randomly divided to enteral nutrition and parenteral nutrition. Complications of the two groups were analyzed using the χ² test. Patient's nutritional data, APACHE II score and Ranson score were analyzed by t test. P<0.05 was considered statistically significant. ResultThere were no statistically significant difference in the nutritional data and the APACHE Ⅱ score and the Ranson score between the two groups before treatment (P>0.05). After treatment, the nutritional data of patients with enteral nutrition were significantly better than those with parenteral nutrition group.The APACHE Ⅱ score and Ranson score of the enteral nutrition group were significantly lower than those of the parenteral nutrition group (P<0.05). The incidence of complications such as renal failure and intraperitoneal infection in patients with enteral nutrition was significantly lower than that in parenteral nutrition group (P<0.05). ConclusionEarly enteral nutrition therapy can effectively improve the nutritional status of patients with severe acute pancreatitis, and improve the immunity of patients, reduce the APACHE Ⅱ, Ranson score and the incidence of complications, which should be widely used in clinical treatment.