重型急性胰腺炎患者营养支持方法的选择  

Choice of Nutrition Support for Severe Acute Pancreatitic Patients

作　　者：孟继明[1] 任学群[1] 

机构地区：[1]河南大学淮河医院,开封市475000

出　　处：《医药论坛杂志》2006年第6期44-45,共2页Journal of Medical Forum

摘　　要：目的探讨重型急性胰腺炎（SAP）合理的营养支持方法。方法将42例患者随机分为两组：全肠外静脉营养（TPN）组、肠内和肠外联合营养（PN＋EN）组，对比分析两组的治疗结果。结果42例中并发症发生率为54．8％，死亡10例，死亡率为23．8％。其中，TPN组并发症发生率为66，7％，死亡率为33．3％：PN＋EN组并发症发生率为42．9％，死亡率为14．3％。两组并发症发生率及死亡率差异均无统计学意义（x^2=2．403，P=0．121；x^2=2．100，P=0．147）．但TPN组营养支持时间为20—64d，平均（30．7±12．1）d；PN＋EN组为14～30d，平均（20．2±5．1）d，两组间差异有统计学意义（t=4．738，P=0．000）。结论肠内和肠外联合营养支持虽不能显著改善重型急性胰腺炎的预后，但可显著缩短营养曼持时间。Objective To explore reasonable nutrition support method for severe acute pancreatitis（SAP）. Methods 42 patients were randomly divided into total parenteral nutrition group （TPN） and enteral nutrition ＋ parenteral nutrition group （ PN ＋ EN）. Treatment results of two groups were compared and analysed. Results In 42 patients,the complication incidence was 54. 8% ,mortality was 23.8% （10/42）. The complication incidence of PN group was 66.7% （ 14/21 ）, mortality was 33.3% （7/21） ; The complication incidence of PN ＋ EN group was 42.9% （9/21）, mortality was 14.3% （3/21）. Complication incidence and mortality of two groups were no significantly difference （X^2 =2. 403, P =0. 121 ;X^2 =2. 100, P =0. 147）. Nutrition supports time in the TPN group and PN ＋ EN group were 20 - 64 days （ 30.7 ± 12.1 ） and 14 - 30 （20.2 ± 5.1 ） days respectively. Two groups were significantly difference（ t = 4. 738, P = 0. 000）. Conclusion PN ＋ EN group couldn’t signifi- cantly improve the prognosis of SAP, but it could notably shorten nutrition supports time.

关 键 词：重型急性胰腺炎 全肠外静脉营养 肠内营养 

分 类 号：R576[医药卫生—消化系统] R459.3[医药卫生—内科学]