摘要
目的 探讨经鼻空肠管早期肠内营养治疗重症急性胰腺炎（SAP）的临床价值。方法 选取2015年2月-2016年2月本院收治的80例SAP患者作为研究对象,根据营养支持方式的不同分为EEN组和TPN组,各40例。比较两组治疗前后的APACHEⅡ评分、Ranson评分、血清白蛋白、血清前白蛋白,记录两组的平均住院费用、住院时间、死亡率、治愈率。结果 两组治疗后的APACHEⅡ、Ranson评分显著低于治疗前,差异有统计学意义（P〈0.05）。TPN组治疗后的体重显著低于治疗前,差异有统计学意义（P〈0.05）。EEN组治疗前后的体重比较,差异无统计学意义（P〉0.05）。两组治疗后的APACHEⅡ、Ranson评分以及体重比较,差异无统计学意义（P〉0.05）。两组治疗后的尿、血淀粉酶水平显著低于治疗前,EEN组治疗后的尿、血淀粉酶水平显著低于TPN组治疗后,差异有统计学意义（P〈0.05）。EEN组治疗后的血清白蛋白、血清前白蛋白水平显著高于治疗前及TPN组治疗后,差异有统计学意义（P〈0.05）。TPN组治疗后的血清前白蛋白水平显著高于治疗前,差异有统计学意义（P〈0.05）。两组的治愈率及死亡率比较,差异无统计学意义（P〉0.05）。EEN组的ARDS、MODS发生率显著低于TPN组,差异有统计学意义（P〈0.05）。EEN组的住院时间显著短于TPN组,住院费用显著低于TPN组,差异有统计学意义（P〈0.05）。结论 经鼻空肠管EEN能够明显改善SAP患者的营养状况,安全性高,可以促进患者康复,值得临床推广应用。
Objective To explore the clinical value of nasal jejunal tube early enteral nutrition in the treatment of severe acute pancreatitis（SAP）.Methods 80 SAP patients from February 2015 to February 2016 in our hospital were selected and divided into the EEN group and the TPN group according to different nutrition support way,40 cases in each group.The APACHE Ⅱ score,Ranson score,serum albumin and pre-albumin in the two groups was compared before and after treatment.The mean hospitalization cost,hospital stay,death rate and cure rate in the two groups was recorded.Results The score of APACHE Ⅱ and Ranson after treatment in the two groups was lower than that before treatment,with significant difference（P〈0.05）.The weight after treatment in the TPN group was lower than that before treatment,with significant difference（P〈0.05）.There was no significant difference in the weight in the EEN group between after treatment and before treatment（P〈0.05）.There was no significant difference in the score of APACHE Ⅱ and Ranson,weight after treatment between the two groups（P〈0.05）.The level of urine and serum amylase after treatment in the two groups was lower than that before treatment,the level of urine and serum amylase after treatment in the EEN group was lower than that after treatment in the TPN group,with significant difference（P〈0.05）.The level of serum albumin and prealbumin after treatment in the EEN group was higher than that before treatment and in the TPN group after treatment,with significant difference（P〈0.05）.The level of serum pre-albumin after treatment in the TPN group was higher than that before treatment The level of serum albumin and pre-albumin after treatment in the EEN group was higher than that before treatment,with significant difference（P〈0.05）.There was no significant difference in the cure rate and mortality between the two groups（P〈0.05）.The incidence rate of ARDS and MODS in the EEN group was lower than that in the TPN group,with significant difference（P〈0.05）.The hospitalization time of the EEN group was shorter than that of the TPN group,and the cost of hospitalization of the EEN group was lower than that of the TPN group,with significant difference（P〈0.05）.Conclusion EEN with nasal jejunum tube can significantly improve the nutritional status of SAP patients,the safety is high,and which can promote recovery of patients,it is worthy of clinical promotion and application.
出处
《中国当代医药》
2016年第18期28-31,共4页
China Modern Medicine
基金
广东省深圳市宝安区科技计划社会公益(医疗卫生类)项目(2015244)
关键词
重症急性胰腺炎
肠内营养
鼻空肠营养管
临床价值
Severe acute pancreatitis
Enteral nutrition
Nose-jejunum nutrition tube
Clinical value
