肠内营养在重症急性胰腺炎中的临床应用

目的探讨肠内营养（EN）在治疗重症急性胰腺炎（SAP）中的应用价值。方法收集2006年1月至2009年6月重症急性胰腺炎患者47例,26例接受经鼻空肠管肠内营养＋肠外营养（EN＋PN）治疗,21例接受全肠外营养（TPN）治疗,比较两组患者症状改善情况、生化指标恢复时间、住院天数、住院费用的差异。结果无一例因鼻空肠管肠内营养的使用而使血尿淀粉酶升高。鼻空肠管肠内营养＋肠外营养比全肠外营养症状体征改善明显,生化指标恢复及住院时间显著缩短,住院费用明显减少（均P〈0.05）。结论 EN＋PN是重症急性胰腺炎治疗的重要手段,合适的肠内营养能有效降低SAP患者感染性并发症的发生和病死率,治疗费用明显减少,缩短了住院天数,值得临床推广。

The clinical of enteral nutrition in treatment of severe acute pancreatitis

Objective To evaluate the therapeutic effect of enteral nutrition on treatment of severe acute pancreatitis(SAP).Methods To collect 47 patients with SAP,admitted from January 2006 to June 2009,of While EN+PN group consisted of 26 patients receiving enteral nutrition through nose-jujunum tube and parenteral nutrition(EN+PN)therapy,and total parenteral nutrition(TPN)group consisted of 21 patients receiving TPN therapy.The differentiation of major causes,treatments and clinical results were analyzed and the length of hospital stay,the costs were compared between two groups.Results There was not a single case in which serum and urine amylase levels elevated because of the use of nasal enteron nutritional support.Compared with TPN group,enteral nutrition shortened the hospital stay and saved the cost(P<0.05).Conclusion EN combined with PN is an important strategy in treatment of severe acute pancreatitis.An appropriate enteral nutrition can greatly lower the incidence of morbidity and mortality,shorten the hospital stay and cutting down on the medical expenses.