Makola Diklar, Krenitsky Joe, Parrish Carol, Dunston Emily, Shaffer Hubert A, Yeaton Paul, Kahaleh Michel
Digestive Health Center, University of Virginia Health System, Charlottesville, Virginia 22908-0708, USA.
Am J Gastroenterol. 2006 Oct;101(10):2347-55. doi: 10.1111/j.1572-0241.2006.00779.x.
Elemental formula delivered distal to the ligament of Treitz has demonstrated efficacy in patients with pancreatitis, presumably by decreasing pancreatic stimulation. Few data exist on the use of standard enteral formula in such patients. This study describes the outcomes of pancreatitis patients managed with long-term standard enteral nutrition (EN).
One hundred twenty-six patients managed at the University of Virginia Health System with pancreatitis requiring nutritional support between August 2000 and June 2004 received a standard formula delivered distal to the ligament of Treitz and were followed prospectively to resolution of their disease process. Predictors of improvement in CT Severity Index, duration of EN, and length of hospital stay were identified. Changes in body weight and serum albumin were determined.
Mean age was 50.8 +/- 15.2 yr (male, 83). Etiology included alcohol (46), gallstones (49), idiopathic (15), post-ERCP (7), drug (5), hyperlipidemia (3), and pancreas divisum (1). EN lasted a median of 18.9 (2.4 to 111.7) wk. Median CT Severity Index decreased from 4 to 2 (p < 0.001). Underweight patients gained 9.8 lbs; overweight and obese patients lost 7.2 and 28.8 lbs, respectively. Albumin concentration increased from 3 to 3.8 g/dL (p < 0.001).
Standard enteral formula is effective in the management of patients with complicated pancreatitis.
在屈氏韧带远端给予要素膳已证明对胰腺炎患者有效,可能是通过减少胰腺刺激实现的。关于在此类患者中使用标准肠内营养制剂的数据较少。本研究描述了接受长期标准肠内营养(EN)治疗的胰腺炎患者的治疗结果。
2000年8月至2004年6月期间,在弗吉尼亚大学卫生系统接受治疗且因胰腺炎需要营养支持的126例患者,接受了在屈氏韧带远端给予的标准营养制剂,并对其进行前瞻性随访直至疾病过程缓解。确定了CT严重指数改善、EN持续时间和住院时间的预测因素。测定了体重和血清白蛋白的变化。
平均年龄为50.8±15.2岁(男性83例)。病因包括酒精性(46例)、胆石症(49例)、特发性(15例)、内镜逆行胰胆管造影术后(7例)、药物性(5例)、高脂血症(3例)和胰腺分裂症(1例)。EN持续时间的中位数为18.9(2.4至111.7)周。CT严重指数中位数从4降至2(p<0.001)。体重过轻的患者体重增加了9.8磅;超重和肥胖患者体重分别减轻了7.2磅和28.8磅。白蛋白浓度从3g/dL升至3.8g/dL(p<0.001)。
标准肠内营养制剂对复杂型胰腺炎患者的治疗有效。