经鼻胃镜放置三腔喂养管治疗重症急性胰腺炎  

Treatment of Severe Acute Pancreatitis with Three-lumen Feeding Tube under Nasal Endoscopy

作　　者：张莉 赵卫川[2] 崔乃强[3] ZHANG Li;ZHAO Wei-chuan;Cui Nai-qiang(Department of Endoscopy Center,Tianjin Nankai Hospital,Tianjin(300100),China)

机构地区：[1]天津中医药大学研究生院,天津300190 [2]天津市南开医院内镜中心,天津300100 [3]天津市南开医院胆胰外科中心,天津300100

出　　处：《中国中西医结合外科杂志》2018年第4期425-428,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:观察鼻胃镜放置三腔喂养管治疗重症急性胰腺炎(SAP)的疗效。方法:回顾性研究SAP患者行全肠外营养(TPN)及肠内营养管(EN)、三腔喂养管治疗,三组各为20例,比较3组治疗前及治疗后20 d血红蛋白、血清总蛋白、血清白蛋白、C-反应蛋白水平变化,以及舒适度评价,统计平均住院天数及住院费用,观察感染发生率、病死率。结果:治疗20 d后EN组、三腔喂养管组血红蛋白较TPN组明显提高(P<0.05)。治疗前后EN组、三腔喂养管组、TPN组的C-反应蛋白与治疗后相比有显著降低[(120.7±84.6)mg/L vs(44.24±29.60)mg/L、(129.1±106.47)mg/L vs(32.15±38.58)mg/L、(99.14±27.15)mg/L vs(8.12±4.26)mg/L(P<0.05)]。EN组、三腔喂养管组住院时间[(73.5±21.1)d、(81.5±41.1)d]、住院费用[(52362.80±2716.3)元、(40477.92±5894.6)元]及感染发生率(16.7%、7.8%)明显低于TPN组[(123.23±12.5)d、(67 416.9±22 659.5)元,56.7%](P<0.05)。三腔喂养管组与EN组相比营养评价无差别,患者舒适度明显优于EN组(P<0.05)。结论:SAP患者经鼻放置三腔喂养管,不仅提供安全有效的营养支持途径,同时减压肠道效果良好,病人舒适度高,在SAP治疗方法中简便、安全、可靠。Objective To observe the effect of nasal endoscopy for three-lumen feeding tube in the treatment of severe acute pancreatitis(SAP).Methods A retrospective study of SAP patients treated with total parenteral nutrition(TPN group,n=20),three-lumen feeding tube(TLFT group,n=20)and enteral nutrition(EN group,n=20)was undertaken.Before and after treatment,hemoglobin,serum total protein,serum albumin,c-reactive protein(CRP),comfort evaluation,average hospitalization days,hospital costs,mortality and infection rate were recorded and compared among three groups.Results After the treatment of 20 d,the levels of hemoglobin in EN and TLFT groups were significantly increased than that in TPN group(P<0.05).The levels of CRP after treatment in three groups were lower than those before treatment,(120.7±84.6)mg/L vs(44.24±29.60)mg/L in EN group,(129.1±106.47)mg/L vs(32.15±38.58)mg/L in TLFT group and(99.14±27.15)mg/L vs(8.12±4.26)mg/L in TPN group,with significant statistic difference(P<0.05).In EN and TLFT groups,the hospitalization time[(73.5±21.1)d and(81.5±41.1)d],hospital costs[(52 362.80±2716.3)Yuan and(40 477.92±5894.6)Yuan]and infection rate(16.7%and 7.8%)were significantly lower than those in TPN group[(123.23±12.5)d,(67 416.9±22 659.5)Yuan and 56.7%](P<0.05).Compared with TFLT group,the nutrition evaluation in EN group has no difference.The comfort degree of patients in TFLT group was higher than that in EN group(P<0.05).Conclusion In SAP patients,treatment with nasal three-lumen feeding tube is a safe and effective way of nutritional support,with good effect of intestinal decompression,and can improve the comfort degree of patients.

关 键 词：三腔喂养管 肠内营养 重症急性胰腺炎 

分 类 号：R657.51[医药卫生—外科学]