重症急性胰腺炎早期肠内营养的实施与护理  

The aplication and nursing of severe acute pancreatitis with early enteral nutrition

作　　者：叶向红[1] 王新颖[1] 倪元红[1] 李维勤[1] 全竹富[1] 彭南海[1] 

机构地区：[1]南京军区南京总医院解放军普通外科研究所,江苏南京210002

出　　处：《肠外与肠内营养》2006年第4期227-230,共4页Parenteral & Enteral Nutrition

基　　金：军队十五医药卫生科研基金重点资助项目(批准号:01Z011)

摘　　要：目的:研究重症急性胰腺炎病人早期肠内营养支持实施的难点,探究一整套重症急性胰腺炎病人早期肠内营养实施的方法。方法:选择普通外科ICU内重症急性胰腺炎病人65例,APACHEⅡ评分均≥8分。在发病后2周内,病人肠道功能存在或恢复时,开始给予肠内营养支持。结果:65例病人在ICU内共行肠内营养1 141 d,65例病人均在发病后1周内开始输注肠内营养,54例病人在1周内达到肠内营养全量;11例病人1周后仍出现腹泻、腹胀、呕吐等而不得不减量或暂停,好转后重新开始,2周内也达到全量。1 141 d的肠内营养中,共发生堵管18次,管道移位3次,管道脱出2次,腹泻43 d,腹痛、腹胀21次,呕吐2次,便秘11 d,气管切开病人无一例出现误吸,代谢观察中发现高血糖17次,均被及时处理。65例肠内营养的病人中,除1例自动出院外,均按期完成肠内营养计划。结论:对重症急性胰腺炎病人急性期实施肠内营养,需通过反复尝试,对症处理。预防和处理胃肠功能紊乱、误吸、代谢紊乱等并发症,是重症急性胰腺炎病人肠内营养时护理的关键内容。Objective ：To explore the key points of the observation and nursing of early enteral nutrition in severe acute pancreatitis and the preventive methods and treatment. Methods ：65 severe acute pancreatitis patients in SICU （APACHEⅡ≥8 ） were administrated enteral nutrition when the enteral function were restored. Results：In the 65 cases with 1 141 days of enteral nutrition, 54 cases arrived total-quantity enteral nutrition within 1 week and 11 cases had to be reduced because of diarrhea, distention or vomiting. When these symptoms were relieved enteral nutrition was restored and reached total quantity in 2 weeks. In 1141 days of enteral nutrition, there were 18 times of tube occlusion, 3 translocation, 2 tube shifting, 43 days of diarrhea, 11 days of constipation, 21 complains of abdominal pain or distention and 2 cases with vomiting. During the period of nutrition, there were 17 times of hyperglycemia. 64 patients completed the expected enteral nutrition and one patient left hospital. points for enteral nutrition in severe acute pancreatitis include preventing Conclusion ： The key nursing and managing the complications such as disorders of enteral or metabolic function and aspiration, as well as modulating the temperature, speed and concentration of enteral nutrition, and keeping the tube unobstructed.

关 键 词：重症急性胰腺炎 早期肠内营养 护理 

分 类 号：R473.6[医药卫生—护理学]