水肿型胰腺炎患者应用肠内营养支持的临床疗效  

Effect of enteral nutrition support on patients with edematous pancreatitis

作　　者：熊焕宏[1] 陈启明[1] 朱思奇[1] 黄磊[1] 

机构地区：[1]北京大学深圳医院急诊科,广东省深圳市518026

出　　处：《中国医药》2017年第8期1197-1200,共4页China Medicine

基　　金：广东省深圳市科技计划（JCYJ20140415162338864）

摘　　要：目的 探讨水肿型胰腺炎患者应用肠内营养支持对患者病情恢复的促进作用。方法 选取2015年6月至2016年6月在北京大学深圳医院进行治疗的水肿型胰腺炎患者共100例；2015年12月之前纳入的52例患者为对照组，2015年12月之后纳入的48例患者为观察组。2组均采用禁食、胃肠减压、抗感染等基础治疗方式，对照组治疗过程中采用持续肠外营养支持，观察组在肠外营养平稳后应用肠内营养支持进行治疗和护理。治疗2周后分析比较2组患者的序贯器官衰竭估计评分、急性生理学与慢性健康状况Ⅱ（APACHE Ⅱ）评分、改良Marshall评分、血糖和尿淀粉酶水平、不良反应发生情况主要症状改善时间和住院时间。结果 治疗后，观察组APACHE Ⅱ评分及改良Marshall评分明显低于对照组［（7.3±1.7）分比（10.0±1.7）分、（0.8±0.6）分比（1.2±0.7）分］，血糖及尿淀粉酶水平明显低于对照组［（6.33±0.16）mmol/L比（6.58±0.11）mmol/L、（327±218）U/L比（544±340）U/L］，继发感染及并发症发生率明显低于对照组［16.7%（8/48）比38.5%（20/52）、25.0%（12/48）比42.3%（22/52）］，全身炎症反应综合征改善时间、体温恢复时间、腹胀腹痛缓解时间及平均住院时间明显短于对照组［（2.61±0.24）d比（5.49±1.31）d、（6.6±1.3）d比（10.2±3.3）d、（2.7±1.0）d比（5.1±1.2）d、（19±7）d比（32±7）d］，差异均有统计学意义（均P＜0.05）。结论 适时地进行肠内营养支持能有效缓解水肿型胰腺炎患者的病情，减少并发症的发生，降低感染率，同时也能加快患者的恢复时间。Objective To explore the effect of enteral nutrition support on prognosis of edematous pancreatitis. Methods Totally 100 patients with edematous pancreatitis were enrolled from June 2015 to June 2016 in Peking University Shenzhen Hospital; patients who were admitted from June to December 2015 had parenteral nutrition support based on fasting, gastrointestinal decompression and anti-infection therapy（control group）; patients who were admitted from December 2015 to June 2016 had enteral nutrition support based on basic therapies（observation group）. After 2 weeks of treatment, scores of Sepsis-related Organ Failure Assessment（SOFA）, Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE Ⅱ） and modified Marshall Scale were evaluated; levels of blood glucose and urine amylase, incidence of adverse reactions, recovery time of main symptoms and length of hospital stay were recorded. Results After treatment, scores of APACHE Ⅱ and modified Marshall Scale, levels of blood glucose and urine amylase, incidences of secondary infection and complications in observation group were significantly lower than those in control group[（7.3±1.7）points vs （10.0±1.7）points,（0.8±0.6）points vs （1.2±0.7）points, （6.33±0.16）mmol/L vs （6.58±0.11）mmol/L,（327±218）U/L vs （544±340）U/L, 16.7%（8/48） vs 38.5%（20/52）, 25.0%（12/48） vs 42.3%（22/52）]（P〈0.05）; systemic inflammatory response syndrome improving time, temperature recovery time, abdominal distension and pain duration time and hospital stay time in observation group were significantly shorter than those in control group[（2.61±0.24）d vs （5.49±1.31）d,（6.6±1.3）d vs （10.2±3.3）d,（2.7±1.0）d vs （5.1±1.2）d,（19±7）d vs （32±7）d]（P〈0.05）. Conclusion Enteral nutrition support can effectively relieve illness, reduce complications and promote recovery in patients with edematous pancreatitis.

关 键 词：水肿型胰腺炎 肠内营养支持 预后 

分 类 号：R576[医药卫生—消化系统]