全肠内营养对急性重症胰腺炎的胰腺坏死性感染的预防作用的研究  

Total enteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis

作　　者：吴兴茂[1] 吉凯强[1] 汪海源[1] 李国福[1] 臧彬[1] 

机构地区：[1]中国医科大学附属盛京医院重症医学科,辽宁沈阳110004

出　　处：《中国现代医学杂志》2013年第4期101-104,共4页China Journal of Modern Medicine

摘　　要：目的本研究评价全肠内营养与全肠外营养对急性重症胰腺炎胰腺坏死性感染的预防作用。方法从2003～2007年共107名ICU患者入选,在入院的1周内,54名患者接受全肠外营养,53名患者接受全肠内营养。所有的患者均给予充分的预防感染治疗。CT及C反应蛋白结果提示两组临床严重程度相似。结果80%的全肠外营养组患者发展成为MODS,明显高于全肠内营养组(21.00%);80.00%全肠外营养及22.00%全肠内营养组患者需外科干预(P<0.05)。全肠内营养组胰腺感染性坏死发生率(23.00%)远远低于全肠外营养组(72.00%)(P<0.05)。全肠外营养组患者死亡率(43.00%)显著高于全肠内营养组(11.00%)(P<0.05)。结论重症胰腺炎中全肠内营养对于预防胰腺坏死性感染优于肠外营养。【Objectives】 This study was designed to evaluate the effects of total enteral nutrition and total parenteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis.【Methods】 107 patients were enrolled in ICU between November 2003 and December 2007.In the first week of hospitalization,54 patients received total parenteral nutrition,and 53 received total enteral nutrition.All patients were concomitantly administered with sufficient prophylactic antibiotics.CT scan and C-reaction proteins indicated a similar clinical severity in both groups.【Results】 80% subjects developed organ failure in the group with total parenteral nutrition,which was significantly higher than that in the group with total enteral nutrition（21.00%）;80.00% patients in total parenteral nutrition and 22.00%（P 0.05） in total enteral nutrition underwent the surgical intervention.The incidence of pancreatic septic necroses in the group with total enteral nutrition（23.00%） was significantly lower than that in the group with total parenteral nutrition（72.00%）（P 0.05）.The mortality of patients（43.00%） on total parenteral nutrition was significantly increased as compared to 11.00%（P 0.05） in the group received total enteral nutrition.【Conclusion】 Total enteral nutrition is better than total parenteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis.

关 键 词：急性重症胰腺炎 全肠内营养 全肠外营养 死亡率 

分 类 号：R576[医药卫生—消化系统] R459.7[医药卫生—内科学]