肠内外营养支持治疗重症急性胰腺炎的效果研究

目的探讨肠内营养和肠外营养支持对于重症急性胰腺炎（SAP）的临床治疗可行性及效果。方法将65例SAP患者随机分为研究组33例和对照组32例，研究组患者均采用肠内营养支持治疗．对照组患者均采用肠外营养支持治疗，比较两组患者危重症评分（APACHE）情况、通便时间、腹痛消失时间及并发症发生率和病死率等。结果两组患者治疗前和治疗当天APACHE评分差异无统计学意义（P〉0．05）。随着治疗时间的增加评分均逐渐下降，研究组治疗后4d评分明显低于对照组（P〈0．05），治疗后7d明显低于对照组（P〈0．01）。研究组通便时间、腹痛消失时间明显短于对照组（P〈0．01）；研究组并发症发生率和病死率明显低于对照组（P〈0．05）；两组患者转手术率差异无统计学意义（P〉0．05）。结论肠内营养支持对于SAP患者的治疗较肠外营养支持效果夏佳，但肠内营养不适于发病初期，因而临床应联合应用肠外和肠内营养支持以达到更好的疗效。

Effect research on enteral and parenteral nutrition support in treatment of severe acute pancreatitis

Objective To discuss the clinical treatment feasibility and effect of enteral and parenteral nutrition support in treatment of severe acute pancreatitis （SAP）. Methods 65 patients with SAP were randomly divided into research group （33 cases） and control group （32 cases）. The research group was given enteral nutrition support treatment, while the control group was given parenteral nutrition support treatment. The APACHE score, defecation time, abdominal pain disappear time, incidence of complications and fatality rate of two groups were compared. Results There were no significant difference in the APACHE score before treatment and treatment day between two groups （P 〉 0.05）. The APACHE score decreased gradually with the increasing of treatment days. The APACHE score in four days and seven days after treatment in research group were lower than that in control group （P 〈 0.05）, especially seven days after treatment （P 〈 0.01）. The defecation time and abdominal pain disappear time in research group ,were shorter than that in control group （P 〈 0.01）, while the incidence of complications and fatality rate in research group were lower than that in control group （P 〈 0.05）. There was no significant difference in the transfer operation rate between two groups （P 〉 0.05）. Conclusion The clinical effect of SAP treated with enteral nutrition support is superior to parenteral nutri tion support, but enteral nutrition support treatment isn＇t very good for taking at the early stage, so enteral combined with parenteral nutrition support treatment should be taken for better clinical effect.