鼻空肠营养在老年胆源性重症急性胰腺炎中的早期应用

目的比较老年胆源性重症急性胰腺炎患者早期应用鼻空肠营养与肠外营养的疗效、住院时间及住院费用。 方法选取2012年1月至2015年12月收治的100例胆源性重症急性胰腺炎患者，年龄均≥60岁，随机分为早期鼻空肠营养管肠内营养（EEN）组及肠外营养（TPN）组，每组50例。比较两组患者营养支持后第7、14天的血淀粉酶、尿淀粉酶、血白蛋白、C反应蛋白、平均住院天数、平均住院费用，以了解两组营养支持方法的治疗效果。 结果（1）营养支持治疗第7天，EEN组血淀粉酶、尿淀粉酶、C反应蛋白较TPN组均明显偏低，差异有统计学意义（t=2.714、11.782、2.310，P=0.008、0.010、0.023），两组血白蛋白水平差异无统计学意义；（2）营养支持治疗第14天，EEN组血淀粉酶、尿淀粉酶、C反应蛋白均较TPN组明显偏低，差异有统计学意义（t=2.218、20.063、10.164，P=0.030、0.014、0.007），EEN组血白蛋白较TPN组明显偏高，差异有统计学意义（t=4.007，P=0.001）；（3）住院期间EEN组死亡患者、平均住院时间、住院费用明显较TPN组少，差异有统计学意义（χ²=4.000，P=0.046；t=2.466，P=0.015；t=2.015，P=0.047）。 结论鼻空肠肠内营养用于老年胆源性重症急性胰腺炎患者可行，临床治疗效果满意，有效减少患者住院时间和费用。

Early application of naso-jejunal feeding tube to elderly patients with biliary severe acute pancreatitis

ObjectiveTo compare the therapy effect, hospitalization time and hospitalization costs between early application of naso-jejunal feeding tube and total parenteral nutrition for elderly biliary severe acute panereatitis patients. MethodsOne hundred elderly biliary acute pancreatitis patients (aged ≥60 years old) between January 2012 and December 2015 were analyzed. They were divided into 2 groups according to the random number table: naso-jejunal feeding tube enteral nutrition (EEN group, 50 patients) and total parenteral nutrition (TPN group, 50 patients). Blood amylase, urinary amylase, blood albumin, C-reactive protein, average hospitalization stay, and average hospitalization costs were detected and compared 7, 14 days after nutritional support, to compare curative effect of the two nutritional support methods. Results(1) 7 days after nutritional support treatment, the level of blood amylase, urinary amylase, C reactive protein in EEN group was lower than TPN group, with significant difference between the two groups (t=2.714, 11.782, 2.310, P=0.008, 0.010, 0.023). There was no significant difference between the two groups in serum albumin. (2) On the 14th day after nutritional support treatment, the level of blood amylase, urinary amylase, C reactive protein in EEN group was lower than TPN group, with significant difference between the two groups (t=2.218, 20.063, 10.164, P=0.030, 0.014, 0.007). The level of blood albumin in EEN group was significantly higher than TPN group (t=4.007, P=0.001). (3) During the period of hospitalization, the mortality, the average length of stay and hospitalization expenses of EEN group were significantly less than those of TPN group, and the differences were statistically significant (χ²=4.000, P=0.046; t=2.466, P=0.015; t=2.015, P=0.047). ConclusionIt is feasible of enteral nutrition for the elderly patients with biliary severe acute pancreatitis, with satisfactory clinical treatment effect and reduced hospitalization time and costs.