重症急性胰腺炎经胃镜放置空肠营养管营养支持的价值  

Clinical value of endoscopic placement of nasojejunal feeding tube for nutritional support in patients with severe acute pancreatitis

作　　者：季峰[1] 焦春花[1] 胡裕耀[1] 徐勤伟[1] 赵瑾[1] 陈卫星[1] 

机构地区：[1]浙江大学医学院附属第一医院消化科,杭州310003

出　　处：《中华消化杂志》2009年第7期446-450,共5页Chinese Journal of Digestion

摘　　要：目的探讨经胃镜放置空肠营养管行肠内营养支持（ENFTP）对重症急性胰腺炎患者的临床价值。方法回顾性分析经ENFTP及同期行完全胃肠外营养（TPN）支持的重症急性胰腺炎患者47例及50例，比较两组患者营养支持前及支持后1、2、4周血常规、血糖、肝肾功能、血脂、血钙水平变化、各种并发症发生率、死亡率、营养支持时间、营养支持平均每日费用、机械通气时间、重症监护病房（ICU）监护时间及平均住院时间。结果营养支持4周后，ENFTP组血红蛋白、白蛋白及空腹高血糖较TPN组恢复显著（P值均〈0．05）；ENFTP组胰周、胆道感染率、导管感染败血症、营养支持时间、营养支持平均每日费用及住院时间均显著低于TPN组（P值均〈0．05），此外ENFTP组能更有效改善APACHEⅡ评分（P〈0．05）。结论ENFTP在重症急性胰腺炎患者中应用安全经济。Objective To evaluate the clinical value of endoscopically nasojejunal feeding tube placement （ENFTP） for nutritional support in patients with severe acute pancreatitis （SAP）. Methods Those SAP patients who treated with ENFTP （n = 47） or with total parenterat nutrition （TPN） （n=50） were retrospectively analyzed for laboratory parameters before and 1,2 and 4 weeks after nutrition support. Outcomes in the two groups were compared with respect to complications, mortality, duration of feeding, feeding costs,mechanical ventilation time and length of ICU or hospital stay. Results Four weeks after nutrition sypport, the hemoglobin and albumin were increased in ENFTP group as compared to TPN groups （P 〈 0. 05）, while the blood sugar was decreased significant in ENFTP group than in TPN group （P〈0.05）. The incidence of peripancreatic or biliary infection and catheter-related infection were lower in ENFTP group than in TPN group. Duration of feeding and hospital stay were shorter, and nutrition cost was lower in ENFTP group （P〈0.05）. In addition, the APACHE Ⅱ score was significantly improved in ENFTP group（P〈0.05）. Conclusion ENFTP seems to be safe and less expensive in treatment of patients with acute pancreatitis.

关 键 词：胰腺炎 急性坏死性 肠内营养 胃肠外营养 完全 

分 类 号：R686[医药卫生—骨科学]