肠内外营养支持治疗重症急性胰腺炎的临床研究与分析

目的比较肠内及肠外营养支持治疗重症急性胰腺炎(SAP)的临床效果,了解肠内营养(EN)的可行性及其优势。方法将65例SAP病人随机分为肠外营养(PN)组和EN组,分别观察营养支持后第1、7、14天的营养状况、免疫学指标,同时比较并发症、感染率、死亡率、住院天数及费用。结果给予营养支持后,两组血清白蛋白、前白蛋白、转铁蛋白显著升高,血糖、血淀粉酶明显降低(P<0·05)。PN组病程后期的IgA较早期明显降低(P<0·05),EN组无明显变化。并发症、感染率、死亡率、住院天数和治疗费用EN组均低于PN组(P<0·05)。结论在无绝对禁忌证的情况下,对SAP患者尽早给予EN是安全和有效的,较PN能够获得更好的营养状态、更少的并发症、更高的生存率、更短的住院时间。

Clinical study of enteral versus parenteral nutrition support in severe acute pancreatitis

Objective To compare enteral nutrition (EN) and parenteral nutrition (PN) in the treatment of severe acute pancreatitis (SAP), in order to elucidate the feasibility and advantage of EN. Method 65 patients were randomly divided into PN and EN groups. The nutritional status and the immunologic index were determined on the 1st, 7th and 14th day after giving the nutritional support, and the incidence of the complications, infection rate, mortality rate, hospital stay days and hospital expenditure were compared. Results After giving the nutritional support, the serum contents of albumin and transferrin were increased obviously, and blood glucose and blood diastase were lowered significantly in both PN and EN groups (P<0.05). In EN group, complications, infection rate, mortality rate, hospital stay days, and hospital fees were significantly lower compared with PN group (P<0.05). In EN group, no obvious change was found on the serum IgA level, while in PN group the IgA level lowered from the beginning. Conclusion It is safe and effective to give early EN support to patients with no contraindication. It was shown that the nutritional status of the patients was markedly improved, complications were reduced, infection rate and mortality rate were lowered, hospital stay days were shortened and expenditure in the hospital was cut down after EN support.