不同时间早期肠内营养对急性重症胰腺炎患者的影响  

Severe Acute Pancreatitis:Effect of Early Enteral Nutrition at different time

作　　者：伏文胜 崔玉静[2] 

机构地区：[1]乌鲁木齐米东区农六师十三户医院内科,新疆乌鲁木齐831401 [2]石河子大学医学院第一附属医院ICU,新疆石河子832008

出　　处：《现代生物医学进展》2010年第3期536-538,共3页Progress in Modern Biomedicine

摘　　要：目的:通过观察不同时间早期肠内营养对急性重症胰腺炎患者的影响,探讨急性重症胰腺炎患者早期肠内营养的最佳时机。方法:将重症急性胰腺炎患者60例分为三组:A组、B组和C组,每组20例。A组为肠外营养组予以常规治疗,B组在常规治疗的基础上通过鼻空肠管在入院3-5天内予以早期肠内营养,C组在常规治疗的基础上通过鼻空肠管在入院5天后予以早期肠内营养。抽取所有患者入院时、入院后3天、7天、14天静脉血,ELISA法测定患者血清中TNF-α、IL-6含量,并记录患者住院期间感染率、病死率、并发症发生率、住院时间、住院费用等。结果:各组患者血清中TNF-α、IL-6含量逐渐下降,B组和C组下降较A组下降明显,差异有统计学意义(P<0.05),B组和C组比较B组予以肠内营养后下降较C组明显,差异有统计学意义(P<0.05)。B组和C组感染率、病死率、并发症发生率、住院时间、住院费用较A组明显低(P<0.05),B组与C组比较感染率、病死率、并发症发生率B组明显低于C组(P<0.05)。结论:早期肠内营养可改善急性重症胰腺炎早期炎症反应,从而减低感染率、病死率、并发症发生率。在患者循环稳定条件下,越早予以肠内营养对患者的预后越有利。Objectives：With the study of severe acute pancreatitis with early enteral nutrition at different time to evaluate the right time of early enteral nutrition in patients with severe pancreatitis.Methods：60 patients with SAP were randomlv divided into three groups,the group A was given conventional therapy,the group B entera1 nutrition by naso1gastric feeding in 3-5 days,the group B entera1 nutrition by nasogastric feeding after 5 days.Plasma TNF-a、IL-6 were measured at the time of entering hospital and at the time of 3 days,7 days, 14 days after hospitalization.We measured the infection rate,the death rate,the complication rate,length of stay and cost of hospitalization. Results：The TNF-a、IL-6 in plasma of the three groups descended,The TNF-a、IL-6 in the group B and group C were significantly lower than that in the group A（P〈0.05）,and group B were significantly lower than that in the group C.The infection rate,the death rate,the complication rate in the group B and group C were significantly lower than that in the group A（P〈0.05）.The infection rate,the death rate, the complication rate in the group B were significantly lower than that in the group C（P〈0.05）.Conclusions：Treatment of SAP with early enteral nutrition can improve nutrition,reduce the infection rate,the death rate,the complication rate.The earlier enteral nutrition,the better to patients.

关 键 词：肠内营养 早期 急性重症胰腺炎 

分 类 号：R657.51[医药卫生—外科学]