营养支持的不同途径对重症急性胰腺炎治疗结局的影响

目的评价经鼻空肠内营养支持在重症急性胰腺炎(SAP)治疗中应用的安全性和有效性。方法通过鼻空肠管实施肠内营养(EN)支持加肠外营养(PN)15例,和完全胃肠外营养(TPN)25例进行比较。结果EN+PN组较TPN组的并发症少(6人次vs43人次,P<0.05),营养状况改善明显,胰腺感染(1人次vs7人次,P<0.05)和二重感染(0人次vs8人次,P<0.05)发生率低,住院时间短(24.20dvs35.46d,P<0.05),住院费用低(3.74万元vs5.82万元,P<0.05)。结论SAP患者实施EN支持是安全和有效的,对消化道功能的恢复,保护肠道粘膜屏障,防止感染,改善机体营养状况大有裨益,但需注意EN的时机。

Effect of Different Pathway for Nutritional Supports in the Treatment of Severe Acute Pancreatitis

Objective To investigate the safety and efficacy of the combined use of enteral nutrition(EN)and parenteral nutrition(PN)in severe acute pancreatitis(SAP). Methods Fifteen patients with SAP received EN and PN,whereas 25 patients with SAP received total PN. Results In EN+PN group,there were less complications,obvious improvement of nutritional condition,lower incidence in pancreatic infection and double infection,shorter time in hospital and lower costs. In EN+PN and TPN groups,the mean hospitalized time was 24.20 and 35.46 days,respectively,the mean costs were 37.400 and 58.200 thousand RMB yuan,respectively. Conclusion It is safe and efficient to carry out the combined use of EN and PN in SAP patients. However,it is important to carefully plan the time to carry out EN.