重症急性胰腺炎患者早期肠内营养支持对腹内压影响的研究  

The impact of early enteral nutrition support on intra-abdominal pressure in patients with severe a cute pancreatitis

作　　者：戴启强[1] 王爱东[1] 方哲平[1] 周蒙滔[2] 

机构地区：[1]浙江省台州医院肝胆外科,浙江台州317000 [2]温州医学院附属第一医院普外科,浙江温州325035

出　　处：《中国现代医生》2013年第33期22-24,共3页China Modern Doctor

基　　金：国家自然科学基金(81070372)

摘　　要：目的探讨SAP患者实施早期肠内营养支持对其IAP的影响。方法回顾性分析2008年6月～2013年5月期间来我院就诊的120例重症急性胰腺炎患者的临床资料,以是否进行早期肠内营养支持进行分组,观察组、对照组各60例,分别实施早期肠内营养支持、全胃肠外营养。结果 (1)治疗第1天观察组与对照组比较IAP值较高,治疗第4、5天降低(P<0.05);与各组入院当日的APACHEⅡ评分、NB值比较,观察组治疗第3天以后、对照组治疗第6天后均出现明显的降低(P<0.05)。(2)观察组与对照组比较,腹痛缓解时间明显较短,行胰腺坏死组织清创术比率明显较低(P<0.05)。(3)IAP值明显正相关于APACHEⅡ评分值、腹痛缓解时间及胰腺清创术比率,负相关于NB值(P<0.05)。结论 SAP患者预后的判断中IAP是一项重要指标,SAP患者实施早期肠内营养支持具有明显的治疗效果可能是因为其能够降低SAP患者的IAP。Objective To investigate the effect of early enteral nut6tion support on the implementation of IAP patients. Methods We retrospective analyzed the clinical data of 120 cases of patients with gevere acute pancreatitis in our hospital collected from June 2008 to May 2013, they were divided into two groups according to the early enteral nutri- tion support, observation group and control group each of 60 cases, the implementation of early enteral nutrition, par- enteral nutrition. Results （1） IAP value on the first day of the observation group was higher than control group, the 4 and 5 days after treatment decreased （P〈O.05）. Compared with APACHE ]1 score, the NB value on the day of each group admitted to hospital, 3 days after treatment of observation group, 6 days after treatment of the control group were sig- nificantly lower （P 〈 0.05）. （2）The abdominal pain relief time of the observation group were significantly shorter than the control group, line of pancreatic necrotic tissue debridement was significantly lower （P 〈 0.05）. （3） lAP value was sig- nificantly associated with APACHE I/ score values, abdominal pain relief time and ratio of pancreatic debridement, negative associated with NB values （P 〈 0.05）. Conclusion The prognosis of patients with SAP, the judgment of the I- AP is an important index in patients with SAP implementation of early enteral nutritional support has obvious thera- peutic effect may be because its can reduce lAP in patients with SAP.

关 键 词：重症急性胰腺炎 早期肠内营养支持 腹内压 

分 类 号：R657.5[医药卫生—外科学]