早期经鼻空肠内营养在重症急性胰腺炎治疗中的安全有效性  

Evaluation of the Salty and Validity of Early Jejunal Nutrition Via Nose on Treating Acute Severe Pancreatitis

作　　者：陈玲玲[1] 王审[1] 颜海帆[1] 陈振华[1] 钟玉芬[1] 

机构地区：[1]温州医学院附属温岭医院消化内科,温岭317500

出　　处：《临床急诊杂志》2007年第4期207-209,共3页Journal of Clinical Emergency

摘　　要：目的探讨早期经鼻空肠内营养在重症急性胰腺炎治疗中的安全有效性。方法回顾分析本院近4年来收治的28例重症急性胰腺炎(SAP)患者,经综合治疗观察症状体征,检测体重、血常规、血清总蛋白、白蛋白、前白蛋白、肝功能、肾功能、电解质(钾、钠)、血糖、淀粉酶、脂肪酶、CRP 和腹部 CT 影像学变化等,判断临床结果。其中营养支持随机分为13例肠内营养(EN)和15例全胃肠外营养(TPN)。结果两组治疗前外周血白细胞计数、肝肾功能等均无显著差异,治疗2～3周后血白细胞和CRP 恢复正常时间 EN 组显著短于 TPN 组(P<0.01),血清白蛋白和前白蛋白水平显著高于治疗前水平(P<0.01和 P<0.001)和 TPN 组治疗后水平(P<0.01和 P<0.001)。结论早期经鼻空肠内营养对重症急性胰腺炎治疗是安全有效的,可促进SAP 患者肝脏蛋白合成,提高血清白蛋白水平和前白蛋白水平,改善 SAP 营养状况,增强肠道黏膜屏障,防止肠内细菌移位,降低机体炎症反应,改善 SAP 的预后。Objective To appraise the safety and validity of early jejunum nutrition via nose on the course on treating severe acute pancreatitis（SAP）. Methods Reviewing and analyzing the 28 patients with SAP those had integrate treatments in our hospital during the past 4 years. We observe their symptoms , signs and weight, blood cell count, serum total protein, albumin, prealbumin, liver function test, renal function test, electrolyte test（potassium and natrium）, blood glucose, amylase, lipase, c-reaction protein（CRP）, abdominal CT and to judge clinical results. 28 patients with SAP were randomly divided into two groups： enteral nutrition （EN） group for 13 patients and total parenteral nutrition （TPN） for 15 patients. Results The total white cell count （ WBC ）, liver function and renal function test were of no significant difference between the two groups before treatment. Two to three weeks after treatment, the recovery of WBC and CRP to normal in EN was significantly shorter than that in TPN group （ P 〈0. 01 ）. After treatment the serum albumin and prealbumin levels in EN group increased significantly （ P 〈0. 01 and P 〈0. 001 ） and were higher than those in TPN group （ P 〈0. 01 and P 〈0. 001 ）. Conclusion Early jejununal nutrition via nose is safe and valid, and can promote albumin synthesis and elevate the serum albumin and prealbumin levels to improve their nutrition in patients with SAP, and may build-up the barrier of enteric mucosa to prevent bacterial shift, reduce systemic inflammatory reaction and improve its prognosis.

关 键 词：急性胰腺炎 空肠内营养 

分 类 号：R657.51[医药卫生—外科学]