全肠内营养在预防重症急性胰腺炎胰腺坏死感染中的作用。

Total enteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis.

机构信息

Intensive Care Unit, Shengjing Hospital, China Medical University, Shenyang, Liaoning Province, China.

出版信息

Pancreas. 2010 Mar;39(2):248-51. doi: 10.1097/MPA.0b013e3181bd6370.

DOI:10.1097/MPA.0b013e3181bd6370

PMID:19910834

Abstract

OBJECTIVE

This study was designed to evaluate the effects of total enteral nutrition and total parenteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis.

METHODS

One hundred seven patients were enrolled in the study between 2003 and 2007. In the first week of hospitalization, they were randomized to feeding by either total parenteral nutrition (54 patients) or total enteral nutrition (53 patients). All patients were concomitantly administered with sufficient prophylactic antibiotics. Computed tomographic scan and C-reactive protein level indicated a similar clinical severity in both groups.

RESULTS

Eighty percent of the patients developed organ failure in the group with total parenteral nutrition, which was higher than that in the group with total enteral nutrition (21%). Eighty percent and 22% (P < 0.05) of the patients in the total parenteral nutrition and total enteral nutrition groups, respectively, underwent surgical intervention. The incidence of pancreatic septic necroses in the group with total enteral nutrition (23%) was lower than that in the group with total parenteral nutrition (72%, P < 0.05). Mortality in the total parenteral nutrition group (43%) was higher than in the total enteral nutrition group (11%, P < 0.05).

CONCLUSION

Total enteral nutrition is better than total parenteral nutrition in the prevention of pancreatic necrotic infection in severe acute pancreatitis.

摘要

目的

本研究旨在评估全肠内营养和全肠外营养在预防重症急性胰腺炎胰腺坏死感染中的作用。

方法

2003 年至 2007 年间，共纳入 107 例患者。住院的第一周，他们被随机分为全肠外营养组（54 例）或全肠内营养组（53 例）喂养。所有患者均同时给予足够的预防性抗生素。计算机断层扫描和 C 反应蛋白水平表明两组的临床严重程度相似。

结果

全肠外营养组 80%的患者发生器官衰竭，高于全肠内营养组（21%）。全肠外营养组和全肠内营养组分别有 80%和 22%（P<0.05）的患者接受了手术干预。全肠内营养组胰腺感染性坏死的发生率（23%）低于全肠外营养组（72%，P<0.05）。全肠外营养组（43%）的死亡率高于全肠内营养组（11%，P<0.05）。