早期肠内营养治疗在重症急性胰腺炎中的应用

目的：观察早期肠内营养治疗重症急性胰腺炎（SAP）的安全性和疗效。方法：2008年1月-2014年1月6年期间收治的82例SAP患者按营养方式不同分为两组，每组41例，采用早期肠内营养治疗为EN组（即入院第3 d置入空肠营养管）；采用肠外营养治疗为PN组；比较2组患者的治疗效果、营养状况的改变以及住院费用，同时比较两组患者入院第3 d和第7 d血浆内毒素水平的变化以及血TNF-α变化。结果： EN组入院第7 d血浆内毒素水平及血TNF-α下降明显。PN组营养支持时间、住院天数、平均住院费用均高于EN组（P＜0.05）。结论：早期肠内营养治疗SAP能改善营养、维护肠道黏膜屏障、减轻炎症反应以及降低住院费用等。

The Application of Early Treatment of Enteral Nutrition in the Severe Acute Pancreatitis

Objective To observe the safety and effectiveness of early treatment of enteral nutrition in pa-tients with severe acute pancreatitis （SAP）. Methods During the last 6 years from January 2008 to January 2014,82 patients with SAP were divided into two groups on the basis of various nutrition support. 41 cases were in early enteral nutrition treatment group （EN group） and the other 41 cases belonged to parenteral nutrition treatment group （PN group）. Effectiveness, changes in nutritional status, cost of hospitalization, the trend of plas-ma endotoxin level and TNF-α in blood before and after the implantation of Jejunum nutrition tube were com-pared between the two groups. Results The abdominal perimeter and abdominal pressure were decreased obvi-ously in both of the treatment groups. But exhaust and defecation shorten time significantly in EN group than PN group. Comparing with PN group, plasma endotoxin level and TNF-α in blood of EN group reduced greatly after the implantation of Jejunum nutrition tube. Nutrition support time, hospital stay and cost of hospitalization in PN group were significantly higher than that in EN group （P＆lt;0.05）. Conclusion Treatment with early enteral nutrition in SAP has advantages in improving body nutritional condition,maintaining intestinal mucosal barrier, alleviating inflammatory reaction in acute phase of acute pancreatitis and reducing medical expenditure.