探讨经鼻空肠管肠内营养方式在中度重症急性胰腺炎治疗中的临床疗效  

Clinical Efficacy of Enteral Nutrition Via Nasojejunal Tube in the Treatment of Moderately Severe Acute Pancreatitis

作　　者：刘利文 马玲莉 董小敏 LIU Li-wen;MA Ling-li;DONG Xiao-min(Department of Critical Care Medicine,Kaifeng People’s Hospital,Kaifeng,Henan,475000,China)

机构地区：[1]开封市人民医院重症医学科,河南开封475000

出　　处：《黑龙江医学》2023年第9期1057-1059,共3页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关项目(201801361)。

摘　　要：目的:分析经鼻空肠管肠内营养方式在中度重症急性胰腺炎治疗中的临床疗效及安全性、耐受性。方法:回顾性分析2019年10月—2021年3月开封市人民医院收治的120例中度重症急性胰腺炎患者资料。分析患者病历资料后根据治疗方案的不同将患者分为对照组与观察组,每组各60例。对照组接受经鼻胃管肠内营养方式干预;观察组接受经鼻空肠管肠内营养方式干预,分析两组患者的治疗疗效,治疗耐受性、安全性,以及患者免疫功能指标、营养状态指标。结果:两组患者均发生喂养不耐受状况,差异无统计学意义(χ^(2)=0.1001,P>0.05);两组患者并发症比较,差异有统计学意义(χ^(2)=6.9818,P<0.05);两组患者启动肠内营养至腹胀腹痛完全消失时间、肠内营养达标时间比较,差异无统计学意义(t=1.0819、0.1803,P>0.05);治疗后,两组患者营养指标均有改善,观察组增加幅度更大,差异有统计学意义(t=7.0798、19.0844、15.4202,P<0.05)。结论:进一步提升中度重症急性胰腺炎患者治疗疗效的营养方式之一则为经鼻空肠管方式,其疗效与经鼻胃管营养方式基本相当,但经鼻空肠管肠内营养方式患者更为耐受,且安全性更高,能够更好地改善患者营养状态和免疫功能。Objective:To analyze the clinical efficacy,safety and tolerability of enteral nutrition via nasojejunal tube in the treatment of moderately severe acute pancreatitis.Methods:The medical records of 120 patients with moderately severe acute pan⁃creatitis admitted to the hospital from October 2019 to March 2021 were retrospectively analyzed,and the patients were divided in⁃to a control group and an observation group according to the treatment plan,with 60 cases in each group.The control group re⁃ceived transnasogastric tube enteral nutrition intervention and the observation group received transnasal jejunal tube enteral nutri⁃tion intervention.The treatment efficacy,treatment tolerability,safety,as well as the indexes of immune function and nutritional sta⁃tus of patients in both groups were analyzed.Results:The feeding intolerance condition occurred in both groups and the difference was not statistically significant(χ^(2)=0.1001,P>0.05).The difference in complications between the two groups was statistically sig⁃nificant(χ^(2)=6.9818,P<0.05).There was no statistically significant difference in the time from initiation of enteral nutrition to complete disappearance of abdominal distension and abdominal pain,and the time to reach the standard of enteral nutrition be⁃tween the two groups(t=1.0819,0.1803,P>0.05).After treatment,nutritional indicators improved in both groups,with a greater increase in the observation group,and the difference was statistically significant(t=7.0798,19.0844,15.4202,P<0.05).Con⁃clusion:One of the nutrition methods to further improve the efficacy of treatment for patients with moderately severe acute pancre⁃atitis is the transnasal jejunal tube method,which is basically equivalent to the transnasal gastric tube nutrition method,but the transnasal jejunal tube enteral nutrition method is more tolerable and safer for patients,and can better improve their nutritional sta⁃tus and immune function.

关 键 词：中度重症急性胰腺炎 肠内营养 经鼻空肠管 经鼻胃管 疗效 安全性 

分 类 号：R735.9[医药卫生—肿瘤]