不同营养支持方式在急性胰腺炎经口进食不耐受患者中的应用效果比较  

Comparison of the effects of different nutritional support methods in acute pancreatitis patients with oral feeding intolerance

作　　者：郝继军 HAO Ji-jun(Department of Critical Care Medicine,Xinwen Central Hospital of Shandong Nursing and Health Group,Tai'an 271219,China)

机构地区：[1]山东颐养健康集团新汶中心医院重症医学科,271219

出　　处：《中国现代药物应用》2024年第14期165-168,共4页Chinese Journal of Modern Drug Application

摘　　要：目的比较急性胰腺炎(AP)经口进食不耐受患者应用不同营养支持方式(经鼻胃管、经鼻空肠管及经肠外营养支持)的效果。方法75例AP经口进食不耐受患者,按营养支持方式不同分为A组(n=30,经鼻胃管营养支持)、B组(n=25,经鼻空肠管营养支持)、C组(n=20,经肠外营养支持)。比较三组患者治疗前后急性生理学及慢性健康状况Ⅱ评分系统(APACHEⅡ)评分、营养指标(血清血红蛋白、白蛋白、前白蛋白)及不良反应发生情况。结果三组患者治疗前APACHEⅡ评分对比,差异不显著(P>0.05);与治疗前对比,三组患者治疗7 d后APACHEⅡ评分均有所降低,差异有统计学意义(P<0.05);三组患者治疗7 d后APACHEⅡ评分对比,差异有统计学意义(P<0.05);治疗7 d后,B组APACHEⅡ评分(15.57±3.54)分低于A组的(18.54±3.22)分和C组的(17.84±2.26)分,差异有统计学意义(P<0.05);A组APACHEⅡ评分与C组对比,差异不显著(P>0.05)。三组患者治疗前血红蛋白、白蛋白、前白蛋白水平对比,差异不显著(P>0.05);治疗7 d后,三组患者白蛋白、前白蛋白水平均较治疗前有所提高,差异有统计学意义(P<0.05);A组和C组血红蛋白水平均较治疗前升高,差异有统计学意义(P<0.05);三组治疗7 d后血红蛋白、白蛋白、前白蛋白水平对比,差异有统计学意义(P<0.05);B组治疗7 d后血红蛋白水平(114.80±15.62)g/L高于C组的(102.88±13.95)g/L,差异有统计学意义(P<0.05);A组和B组治疗7 d后白蛋白、前白蛋白水平分别为(32.65±4.05)g/L、(227.64±47.24)mg/L和(30.84±3.72)g/L、(200.64±35.26)mg/L,均高于C组的(28.52±3.28)g/L、(160.27±36.81)mg/L,差异有统计学意义(P<0.05)。三组患者治疗后不良反应发生率对比,差异不显著(P>0.05)。结论在AP经口进食不耐受患者中,应用经鼻胃管、经鼻空肠管的营养支持比经肠外营养支持疗效更佳,对改善患者营养水平、降低不良反应发生率更有益。Objective To compare the effect of different nutritional support methods(nasogastric tube,nasojejunal tube and parenteral nutritional support)in acute pancreatitis(AP)patients with oral feeding intolerance.Methods 75 AP patients with oral feeding intolerance were divided into group A(n=30,nasogastric tube nutritional support),group B(n=25,nasojejunal tube nutritional support)and group C(n=20,parenteral nutritional support)according to different nutritional support methods.The Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)scores,nutritional indexes(serum hemoglobin,albumin,prealbumin)before and after treatment and adverse reactions were compared among the three groups.Results There was no significant difference in APACHEⅡscores among the three groups before treatment(P>0.05).Compared with before treatment,APACHEⅡscores of the three groups were decreased after 7 d of treatment,and the difference was statistically significant(P<0.05).After 7 d of treatment,APACHEⅡscores of the three groups were compared,and the difference was statistically significant(P<0.05).After 7 d of treatment,APACHEⅡscore in group B was(15.57±3.54)points,which was lower than(18.54±3.22)points in group A and(17.84±2.26)points in group C,and the difference was statistically significant(P<0.05).There was no significant difference in APACHEⅡscore between group A and group C(P>0.05).There were no significant differences in the levels of hemoglobin,albumin and prealbumin among the three groups before treatment(P>0.05).After 7 d of treatment,the levels of albumin and prealbumin in three groups were increased compared with those before treatment,and the difference was statistically significant(P<0.05).The hemoglobin levels in group A and group C were higher than those before treatment,and the difference was statistically significant(P<0.05).After 7 d of treatment,the levels of hemoglobin,albumin and prealbumin in three groups were compared,and the differences were statistically significant(P<0.05).The hemoglobin level of gro

关 键 词：急性胰腺炎 鼻胃管 鼻空肠管 肠外营养 营养支持 

分 类 号：R576[医药卫生—消化系统] R459.3[医药卫生—内科学]