早期肠内营养治疗对重症急性胰腺炎的疗效分析

目的：评价不同时间的早期肠内营养（EN）支持在重症急性胰腺炎（SAP）治疗中的作用。方法回顾性分析36例SAP患者的临床资料。所有患者均给予常规治疗，并于SAP治疗后24~48 h、49~72 h、＞72 h应用EN治疗，并据此分为A、B、C 3组。 EN治疗第7天进行血清白蛋白（ALB）、血清前白蛋白（PA）、淋巴细胞计数（TLC）、白细胞计数、血清降钙素原（PCT）、C反应蛋白检查，记录首次排便时间、急性生理与慢性健康评分（APACHEⅡ）、Balthaz-ar CT 评分、腹胀缓解时间，统计胰周感染发生率、假性囊肿发生率、病死率、住院时间、住院费用等临床资料。结果A组12例，B组8例，C组16例。A组PA、TLC、白细胞计数、PCT、C反应蛋白、首次排便时间、腹胀缓解时间、假性囊肿发生率均显著优于C组（P＜0.05）。 A组ALB、PA、白细胞计数、C反应蛋白、住院时间显著优于B组（P＜0.05）。结论对不同的治疗时间而言，SAP治疗后24~48 h进行EN治疗可能更有利于提高SAP的治疗效果。

The efficacy of early enteral nutrition therapy on severe acute pancreatitis

Objective To analyze the effect of different periods of early enteral nutrition(EN) support on severe a-cute pancreatitis (SAP). Methods Retrospective analysis of 36 patients with SAP were performed .The patients were di-vided into A,B,C groups according to the timing of EN (24-48 h, 49-72 h, >72 h). ALB, PA, TLC, WBC, PCT, CRP, first defecation time, APACHE Ⅱ score, Balthazar CT score, abdominal distension relief time, peripancreatic infection inci-dence, pseudo-cyst formation rate, mortality, hospital stay, and medical fees were compared between the three groups. Re-sults There were 12 cases in group A,8 cases in group B,16 cases in group C. PA, TLC, WBC, PCT, CRP, first defeca-tion time, abdominal distension relief time, pseudo-cyst formation rate in group A were superior to those of group C (P<0.05). ALB, PA, WBC, CRP, and hospital stay in group A were superior to group B(P<0.05). Conclusion EN which was given after 24-48 hours of SAP may get better effect.