早期经口进食对小儿轻症急性胰腺炎的疗效影响  

Therapeutic effect of early oral feeding on pediatric mild acute pancreatitis

作　　者：刁维 何凤[1] Diao Wei;He Feng(Department of Pediatric Surgery,Affiliated Hospital,North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院小儿外科,四川省南充市637000

出　　处：《临床小儿外科杂志》2021年第7期631-634,共4页Journal of Clinical Pediatric Surgery

基　　金：南充市市校科技战略合作项目(编号:18SXHZ0332)。

摘　　要：目的探讨早期经口进食对小儿轻症急性胰腺炎(pediatric mild acute pancreatitis,PMAP)的疗效影响。方法将川北医学院附属医院小儿外科收治的36例轻症急性胰腺炎患者分为对照组(n=16)与研究组(n=20)。对照组按照传统治疗方案治疗(常规禁食1~7 d,再根据腹痛症状、饥饿感、不良体征、血胰淀粉酶和脂肪酶变化特征及胃肠道功能恢复情况决定经口进食时机);研究组早期开始经口进食清淡、流质、无脂饮食。观察两组患者治疗第1天、第4天、第7天的血清淀粉酶、血清脂肪酶和C反应蛋白(C-reactive protein,CRP)的水平,同时观察两组患者疼痛程度、住院时间及并发症发生率,并进行统计分析。结果两组患者经治疗后的血清淀粉酶、血清脂肪酶及CRP均明显降低,第1天、第4天、第7天上述三项指标差异均无统计学意义(P>0.05)。两组患者在治疗前3天均有不同程度的腹痛,但整体呈好转趋势。是否经口进食与腹痛没有相关性。对照组与研究组的住院时间分别为(11.63±2.00)d和(9.90±1.86)d,差异有统计学意义(t=2.682,P<0.05)。两组恶心、呕吐、腹胀、腹泻等并发症发生率的差异均无统计学意义(P>0.05)。结论相较于传统禁食方案,MAP患者早期经口进食可能有助于缩短住院时间,不加重炎症、腹痛的程度,以及增加并发症发生率。Objective To explore the therapeutic effect of early oral feeding on pediatric mild acute pancreatitis(PMAP).Methods A total of 36 PMAP children were divided into two groups of control(n=16)and study(n=20).The control group received a traditional treatment regimen,i.e.routine fasting for 1 to 7 days and then timing of oral feeding was determined by the relief of abdominal pain symptoms,hunger,disappearance of adverse signs,normalization of blood pancreatic amylase and lipase and recovery of gastrointestinal function.The study group began to resume a light,liquid and fat-free diet.The serum levels of amylase,lipase and C-reactive protein(CRP)of two groups at treatment day 1/4/7 were observed and analyzed statistically.Severity of pain(from Day 1 to 3),length of hospital stay and incidence of complications were recorded and analyzed statistically.Results After treatment,serum levels of amylase,lipase and CRP of two groups decreased markedly.And no statistical difference existed in three indices at Day1/4/7.Two groups had varying degrees of abdominal pain at Day 3 after treatment.However,the overall trend improved.No correlation existed between early oral feeding and abdominal pain.The length of stay was(11.63±2.00)versus(9.90±1.86)days in control and study groups respectively and the difference was statistically significant(P<0.05).No significant inter-group difference existed in the incidence of nausea,vomiting,abdominal distension,diarrhea or other complications.Conclusion Early oral feeding of PMAP may achieve a shorter hospital stay than traditional fasting,without an aggravation of inflammation,abdominal pain and complications.

关 键 词：胰腺炎 急性坏死性/膳食疗法 胰腺炎 急性坏死性/治疗 治疗结果 

分 类 号：R725.761[医药卫生—儿科] R459.3[医药卫生—临床医学]