重症急性胰腺炎营养支持的临床研究  

Clinical study on nutritional support for severe acute pancreatitis

作　　者：杨洪[1,2] 谢晓 彭小云[1,2] 

机构地区：[1]重庆市第四人民医院 [2]重庆市急救医疗中心肝胆胰外科,400014

出　　处：《重庆医学》2015年第7期934-936,共3页Chongqing medicine

摘　　要：目的探讨肠内营养(EN)联合肠外营养(PN)支持对重症急性胰腺炎(SAP)治疗预后的影响。方法选择重庆市急救医疗中心2011年7月至2012年6月临床确诊SAP患者61例,随机分为早期给予EN联合PN(EN+PN组)30例,给予单纯PN(PN组)31例。测量入院后第1、2、3、5、7、10、14天体质量指数(BMI),记录有无并发症,首次肛门排气、排便时间,住院总时间,住院总费用及药品比重,血尿淀粉酶恢复正常时间等指标。结果治疗后,两组患者BMI前3d变化不大,但第5、7、10、14天时两组比较差异有统计学意义(P<0.05);肠鸣音恢复正常时间和肛门排气时间、住院总费用、并发症发生率比较,差异有统计学意义(P<0.05),而血、尿淀粉酶恢复时间及住院总时间方面两组比较差异无统计学意义(P>0.05)。结论与单纯PN相比,EN联合PN的治疗方法能改善患者营养状况,减少因消耗带来的体质量减轻,促进肠道蠕动,有效减少菌群异位导致的感染性并发症,减轻患者的经济负担。Objective To explore the effect of enteral nutrition combined with parenteral nutrition support on the prognosis of severe acute pancreatitis（SAP）. Methods Sixty-one patients diagnosed with SAP in our hospital from July 2011 to June 2012 were chosen and randomly divided into EN and PN group（30 cases） and PN group（31 cases）. At the early stage of treatment, the former group was provided parenteral nutrition（PN） alone while the latter group was given enteral nutrition together with parenter- al nutrition. Then we measured the patientsr body mass index on the 1 st, 2nd, 3rd, 5th, 7th, 10th, 14th day respectively after admis- sion, and recorded the following indexes：whether complications occurred or not, the time for the first passage of gas by anus and defecation, the total time and cost of hospitalization, the drug proportion and the time the serum and urine amylase returned to nor- mal. Results The two groups of patientsr body mass index showed no significant differences in the first 3 days,but there were sig- nificant differences in statistics on the 5th,Tth,10th and 14th day（P〈0.05）. In addition,the two groups of patients formed a sharp contrast in such aspects as the bowel sound recovery time, the anal exhaust time, the total cost of hospitalization and the incidence rate of the complications（P〈0.05） whereas there were no remarkable differences in the serum and urine amylase recovery time and the total time of hospitalization（P〉0.05）. Conclusion Compared with PN,the combined therapy of EN and PN could improve the patients＇ nutrition, reduce the weight loss caused by consumption, promote intestinal peristalsis, effectively reduce infectious compli- cations caused by floraectopic and ease the patients financial burden.

关 键 词：重症急性胰腺炎 肠内营养 肠外营养 

分 类 号：R576[医药卫生—消化系统]