肠内营养在急性重型胰腺炎治疗中的应用

目的观察肠内营养（EN）在急性重症胰腺炎（SAP）治疗中的临床应用价值。方法将50例SAP患者随机分为非EN组（25例）和EN组（25例）。非EN组予以抗感染、抑制胰酶活性、减少胰腺分泌、抑酸、维护内环境稳定等治疗。EN组除接受与非EN组相同的治疗外,据患者体重按25-30KJ/Kg能量需要量,给予EN 10天。所有患者均监测治疗前、治疗10天时的外周血WBC计数、淋巴细胞计数、Alb、血清内毒素、体温,并评定治疗前、治疗10天时的Ranson评分、APACHE评分。观察EN组患者在给予EN时有无腹痛、发热加重、呕吐、腹泻等表现。结果与非EN组对比,EN可使SAP外周血WBC计数明显下降,T〉37℃持续天数更短,血清内毒素水平明显下降,外周血淋巴细胞计数明显上升,血清白蛋白明显升高,Ranson评分、APACHE评分明显降低。EN治疗时,患者均无腹痛、发热加重,无呕吐。结论 SAP的治疗中EN是一重要、有效、安全的治疗手段。

Enteral nutrition in sever acute pancreatitis

Objective To observe the effect of EN in the therapy of SAP and establish the value of clinic performance of EN in SAP.Methods 50 patients with SAP were randomly enrolled into two groups.The patients of one group（non-EN group） were given the therapy of anti-infection,inhibited the activity of pancreatic enzyme,reduced the secretion of pancreatic fluid and gastric acid and maintain body internal environment.The patients of another group （EN group） were given the therapy of enteral nutrition for 10 days and the same therapy in non-EN group.The account of WBC and lymphocyte in PLMP,the plasma concentration of albumin and endotoxin,body temperature,Ranson score,and APACHE score were observed in the time of pro-therapy and 10 days of post-therapy.The performance of abdominal pain,fever,vomit,and so on was observed.Results Compared with non-EN group,the account of WBC and lymphocyte in PLMP descended and ascended more respectively,the plasma concentration of albumin ascended more,but that of endotoxin descended more,the duration of fever（body temperature above 37℃） was shorter,Ranson score,and APACHE score were lower in the time of 10 days of post-therapy in EN group.The patients in EN group had no performance of abdominal pain and fever being severer,vomit,and so on.Conclusion EN is important,effective and safe for SAP.