不同营养支持方式对急性胰腺炎预后影响  

Effect of nutritional support on the prognosis of patients with acute pancreatitis

作　　者：杨蕾[1] 徐静[1] 赖晓蕊 徐境一 王鑫[1] YANG Lei;XU Jing;LAI Xiao-rui;XU Jing-yi;WANG Xin(Deparlment of Nutrition,The General Hospital of Shenyang Military Command,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院营养科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第7期790-793,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨不同营养支持方式对急性胰腺炎(AP)预后影响。方法选取沈阳军区总医院收治的236例AP患者为研究对象,根据营养支持方式的不同,分为常规组和观察组,每组各118例。常规组予以单纯全胃肠外营养支持(TPN)治疗,观察组予以氨基酸型肠内营养剂(EN)治疗,观察两组血清淀粉酶(AMS)、尿淀粉酶(UAMY)恢复正常的时间,比较治疗前及治疗后7、14、28 d的血清白蛋白(ALB)、血清前白蛋白(PA)体质量、急性生理与慢性健康评分(APACHE-Ⅱ)评分变化以及患者满意度,统计两组治疗28 d并发症的发生情况。结果观察组AMS、UAMY恢复正常的时间为(6.38±0.95)d、(7.49±0.78)d,均明显低于常规组的(7.45±0.52)d、(9.16±1.17)d,两组间比较,差异均有统计学意义。两组治疗后7、14、28 d,ALB、PA指标、APACHE-Ⅱ评分均有明显改善,且观察组的改善程度均明显高于常规组,差异均有统计学意义(P<0.05)。治疗前及治疗后7、14、28 d,两组体质量水平比较,差异均无统计学意义(P>0.05)。观察组和常规组总并发症的发生率分别为7.6%(9/118)和11.9%(14/118),两组间比较,差异有统计学意义(P<0.05)。观察组患者总满意度为90.7%(107/118),常规组为85.6%(101/118),两组间比较,差异有统计学意义(P<0.05)。结论 EN可显著改善患者的临床症状,患者AMS、UAMY恢复时间更快,不同时间节点的ALB、PA指标恢复效果更好,并发症的发生率更低,患者满意度高。Objective To investigate the different nutritional support methods on the prognosis of patients with acute pancreatitis.Methods A retrospective study was performed on 236 cases of patients with acute pancreatitis（ AP） who were admitted. According to the different nutritional support methods,patients were divided into the conventional group and the observation group,with 118 cases in each group. Patients in the conventional group were given total parenteral nutrition（ TPN） treatment,the others in the observation group were treated with Amino Acid enteral nutrition（ EN）. The serum amylase（ AMS） and urine amylase（ UAMY） recovery time were observed between the two groups,the changes of serum albumin（ ALB）,prealbumin（ PA）,body mass and APACHE-Ⅱ score were compared before and after the treatment in Day 7,14 and 28,the patients were asked to completed satisfaction questionnaire,and complications were calculated in the two groups during 28 days. Results In the observation group,the recovery time of AMS and UAMY was（ 6. 38 ± 0. 95） days and（ 7. 49 ± 0. 78） days,which were significantly lower than（ 7. 45 ± 0. 52） days and（ 9. 16 ± 1. 17） days in the conventional group（ P〈0. 05）. After the treatment,the ALB and AP indexes of the corresponding time points（ Day 7,14 and 28） were significantly higher than those of the conventional group（ P〈0. 05）. There was no statistically significant difference in body mass between the two groups before and after treatment at all time points（ P〉0. 05）. The total complication rate in the observation group was7. 6%（ 9/118）,which was statistically significant different from 11. 9%（ 14/118） in the conventional group（ P〈0. 05）. The overall patient satisfaction in the observation group was 90. 7%（ 107/118）,which was statistically significant different from 85. 6%（ 101/118） in the conventional group（ P〈0. 05）. Conclusion EN can significantly improve the symptoms of AP patients,AMS and UAMY recovery t

关 键 词：营养支持 急性胰腺炎 预后 满意度 

分 类 号：R657.5[医药卫生—外科学]