早期肠内营养对重症急性胰腺炎患者临床预后的随机对照研究

目的]了解早期肠内营养对重症急性胰腺炎患者预后的影响。方法]采用随机对照试验设计。纳入符合重症急性胰腺炎诊断标准的患者40例。分为研究组和对照组。研究组由鼻空肠营养管给以氨基酸型肠内营养,对照组经锁骨下中心静脉置管输注输入肠外营养。两组均达到非蛋白热卡(20±2)kcal/kgd-1,氮0.2g/kgd-1(氨基酸1.5g/kg)的喂养目标。营养支持在患者入组后12h内开始。结果]研究组20例患者入组,19例完成研究;对照组20例,均完成研究。两组患者之间的住院期间死亡率比较,未发现差异有统计学意义,但在完成研究的患者间的分析,发现研究组死亡率有下降趋势。患者的胰腺感染发生率和手术率,研究组显著低于对照组。研究组的住院时间(24.1±5.3)dvs.(34.5±9.3)d,t=-2.615,P﹤0.0001)],住ICU时间(14.6±8.7)dvs.(25.7±11.9)d,t=-4.197,P﹤0.01]显著少于对照组。结论]早期肠内营养可显著改善重症急性胰腺炎患者的临床结局。

EVALUATION OF THE EFFECT OF EARLY ENTERAL NUTRITION ON CLINICAL OUTCOMES IN SEVERE ACUTE PANCREATITIS PATIENTS

Objective]To evaluate the effect of early enteral nutrition on clinical outcomes in severe acute pancreatitis(SAP)patients.Methods]A prospective,randomized and controlled study was taken.Forty patients were randomly allocated to receive an enteral nutrition or a control isocaloric,isonitrogenic parenteral nutrition.The death occurrence,infectious complication of pancreas,operation,length of hospital stay(LOS),and length of ICU stay were recorded.SPSS 11.5 was used for statistical analysis.Results]Thirty-nine patients successfully completed nutrition therapy(19 in enteral nutrition group and 20 in parenteral nutrition group).The number of infected patients was significantly higher in the PN group,and significantly much more patients have been undergone operation.The length of hospital stay in the glutamine enriched EN group was(24.1±5.3)days,which was significantly less than PN group(34.5±9.3 days,t =-2.615,P﹤0.0001).The ICU stay was shorten in EN group(14.6±8.7 days vs.25.7±11.9 days,t =-4.198,P﹤0.01).Conclusion]Early enteral nutrition may improve the clinical outcome of severe acute pancreatitis.