重症急性胰腺炎患者早期应用肠内营养疗效观察

目的 观察重症急性胰腺炎患者早期应用肠内营养疗效.方法 选择上海市长宁区中心医院重症监护室2011年7月至2013年4月治疗的18例重症急性胰腺炎患者,将患者完全随机分为早期肠内营养治疗组和常规肠内营养治疗组,各9例,比较2组患者重症监护时间、住院时间和并发症发生率.结果 早期肠内营养治疗组和常规肠内营养治疗组重症监护时间分别为（15.4±1.6）、（39.1±1.5）d,组间差异有统计学意义（P〈0.05）;住院时间和分别为（25.9±1.8）、（79.2±1.4）d,组间差异有统计学意义（P〈0.05）;早期肠内营养治疗组发生腹胀3例（33.3%）,腹腔内出血1例（11.1%）,肠瘘1例（11.1%）,肺部感染4例（44.4%）;常规肠内营养治疗组发生腹胀5例（55.6%）,腹腔内出血2例（22.2%）,肠瘘 1例（11.1%）,肺部感染5例（55.6%）.2组患者腹胀、腹腔内出血、肺部感染并发症发生率比较差异均有统计学意义（均P〈0.05）.结论 早期应用肠内营养可缩短重症急性胰腺炎患者的平均住院时间,并降低并发症发生率.

The application of early enteral nutrition in patients with severe acute pancreatitis

Objective To investigate the timing and clinical advantages of early enteral nutrition（EN） in patients with severe acute pancreatitis（SAP）. Methods Eighteen cases of SAP were randomly divided into early EN group and conventional EN group,with 9 cases in each group. The intensive care time, the average hospitalization day and complication were analyzed. Results In early EN group, the intensive care time was （15.4±1.6）d and the conventional EN group was（39.1±1.5）d, the difference between two groups was statistically significant（P〈0.05）. In early EN group,the average hospitalization day was（25.9±1.8）d; in conventional EN group, the average hospitalization day was （79.2±1.4）d; the difference between two groups was statistically significant（P〈0.05）. In the early EN group, the proportion of patients with abdominal distension, intraperitoneal hemorrhage, intestinal fistula and pulmonary infection were 3 cases（33.3%）, 1 case（11.1%）, 1 case（11.1%） and 4 case（44.4%） respectively. In the conventional EN group,the proportion of patients with abdominal distension, intraperitoneal hemorrhage, intestinal fistula and pulmonary infection were 5 cases（55.6%）, 2 cases（22.2%）, 1 cases（11.1%） and 5 cases（55.6%） respectively. There were significant differences between early EN group and conventional EN group in abdominal distension, intraperitoneal hemorrhage, intestinal fistula and pulmonary infection respectively. Conclusion Early application of enteral nutrition is safe and can reduces the average length of hospital stay and complications.