Vieira Josiel Paiva, Araújo Gutemberg Fernandes de, Azevedo José Raimundo Araújo de, Goldenberg Alberto, Linhares Marcelo Moura
Surgical Department, Federal University of Maranhao, Brazil.
Acta Cir Bras. 2010 Oct;25(5):449-54. doi: 10.1590/s0102-86502010000500012.
To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization.
The study was comprised of 31 patients, divided into a parenteral group (n=16) and an enteral group (n=15), who met severity criteria for abdominal tomography (Balthazar classes C, D, and E). The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression.
There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10). Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006). There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group.
Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support.
比较肠外营养支持与肠内营养支持在重症急性胰腺炎治疗中的效果，包括疗效、安全性、发病率、死亡率及住院时间。
该研究纳入31例符合腹部断层扫描严重程度标准（巴尔萨泽分级C、D和E级）的患者，分为肠外营养组（n = 16）和肠内营养组（n = 15）。对患者的人口统计学特征、疾病病因、抗生素预防使用情况、是否使用生长抑素、营养支持、并发症及疾病进展进行比较。
两组在营养支持、生长抑素或抗生素的平均使用时长上无统计学差异。亚胺培南是两组预防胰腺感染的首选药物。肠外营养组出现的并发症更多，尽管差异无统计学意义（p = 0.10）。肠外营养组的感染性并发症，如导管败血症和胰腺组织感染，明显更为常见（p = 0.006）。两组的平均住院时间无差异。肠外营养组有3例死亡，肠内营养组无死亡病例。
与肠外营养支持相比，肠内营养支持与较少的感染并发症相关。
