经鼻空肠管肠内营养在急性重症胰腺炎患者中的应用

目的探讨经鼻空肠管行肠内营养在急性重症胰腺炎患者中的应用。方法将急性重症胰腺炎30例随机分为肠内营养组（EN组）（16例）和全胃肠外营养组（TPN组）（14例），观察两组治疗结果以及临床指标的变化。结果营养支持2周后两组患者的APACHEⅡ评分、CT评分较前显著降低（P〈0．01），且EN组的各项评分均显著低于TPN组（P〈0．01）。营养支持后两组的血清白蛋白均较前有明显改善（P〈0．01），但两组比较无显著性差异（P〉0．05）。EN组治疗后血清前白蛋白水平与治疗前明显增高（P〈0．05），且与TPN组比较亦有显著性增加（P〈0．05）。EN组平均住院天数显著缩短，中转手术率、感染率、死亡率方面EN组均显著低于PN组（P〈0．05），且MODS发生率两组有显著性差异（P〈0．01）。结论经鼻空肠管肠内营养支持方式的疗效优于完全胃肠外营养，对重症急性胰腺炎的治疗起了积极作用。

The Enteral Nutrition by Naso-jejunal Tube in Acute Severe Pancreatitis

Objective To explore the application of enteral nutrition by naso-jejunal tube in acute severe pancreatitis. Methods The 30 patients were randonly divided into enteral nutrition group（n=16） and total parenteral nutrition（TPN）group（n= 14）.The changes of clinical indicators and clinical outcome were recorded.Results Two weeks after nutritional support, the APACHE Ⅱ score and CT score were significantly lower in the EN group than in the TPN group（P〈0.01）.The serum albumin in both two groups were notably improved（P〈0.01）, however, no significant difference was found between these two groups（P〉0.05）.Serum prealbumin level was notably elevated in EN group as compared to the baseline and that in TPN group （P〈0.05）.The average hospital stay was also notably shortened in the EN group.The incidence of shift to operation ,complications and mortality were significantly lower in the EN group than in the TPN group（P〈0.05）. Enteral nutrition diminished the rate of MODS. Conclusion The enteral nutrition by naso-jejunal tube can remarkably improve the nutritional status of patients with severe acute pancreatitis.