营养支持在妊娠合并急性胰腺炎中的应用及疗效初步评价  

Application and preliminary evaluation of nutritional support in acute pancreatitis of pregnancy

作　　者：骆文君 李春花[1] 林辉[1] 郑媛钰 

机构地区：[1]第三军医大学新桥医院消化内科,重庆400037

出　　处：《第三军医大学学报》2017年第13期1400-1403,共4页Journal of Third Military Medical University

基　　金：第三军医大学新桥医院临床科研项目(2013XQHLYG-14)~~

摘　　要：目的评价营养支持在妊娠合并急性胰腺炎患者中的应用及其疗效。方法以我科2013年1月至2016年6月期间住院治疗的全部31例妊娠合并急性胰腺炎患者为研究对象,描述营养支持的应用,并比较肠外营养(parenteral nutrition,PN)与肠外营养联合肠内营养(enteral nutrition,EN)应用的临床效果。结果妊娠合并轻症急性胰腺炎患者8例(25.81%)均未进行营养支持,妊娠合并中重症急性胰腺炎患者中,分别有32.26%(10/31)和41.94%(13/31)的患者采用PN、PN和EN联合进行营养支持。PN和EN联合营养支持治疗组的感染发生率(18.18%)、腹胀缓解时间(3.85±1.07)d、体温恢复正常时间(6.31±2.29)d、住院时间以及住院费用均显著低于PN支持治疗组(P<0.05),但不同营养支持方式治疗组间的胎儿终止妊娠率、早产率和足月生产率差异无统计学意义(P>0.05)。结论在妊娠合并急性胰腺炎病例中,营养支持应用广泛;肠外营养与肠内营养联合营养支持总体临床效果优于肠外营养。Objective To investigate the application and evaluate the effects of different nutritional support therapies in the pregnant women with acute pancreatitis. Methods Thirty-one pregnant women with acute pancreatitis admitted in our department from January 2012 to June 2016 were recruited in this study. The differences between the nutritional status of patients who accepted parenteral nutrition （PN） alone or combined parenteral and enteral nutrition （PN ＋ EN ） were described and evaluated for clinical efficacy. Results There were 8 patients （8/31, 25.81% ） with mild acute pancreatitis treated with no any nutritional support therapy. Ten of the 31 patients （ 10/31, 32.26% ） with moderate pancreatitis were treated with PN alone, and the left 13 （13/31, 41.94% ） were treated with PN ＋ EN. The PN ＋ EN group had an infection incidence of 18.18%, bradycardia duration of 3.85 ± 1.07 d, and time of returning to normal temperature of 6.31 ± 2.29 d. The length of hospital stay and the hospitalization costs were significantly lower in the PN ＋ EN group than the PN group （ P 〈 0.05 ）. However, there were no significant differences in the terminating pregnancy rate, preterm birth rate and term birth rate between the 2 groups （P 〉 0.05）. Conclusion In the cases of acute pancreatitis in pregnancy, nutritional support should be widely applied. PN ＋ EN is superior to PN alone in clinical practice.

关 键 词：急性胰腺炎 妊娠 肠外营养 肠内营养 

分 类 号：R459.3[医药卫生—治疗学] R576[医药卫生—临床医学]