Singh Akanand, Chen Ming, Li Tao, Yang Xiao-Li, Li Jin-Zheng, Gong Jian-Ping
Chongqing Key Laboratory of Hepatobiliary Surgery and Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
ISRN Gastroenterol. 2012;2012:791383. doi: 10.5402/2012/791383. Epub 2012 Dec 11.
Background and Aims. Nutritional support in severe acute pancreatitis (SAP) is controversial concerning the merits of enteral or parenteral nutrition in the management of patients with severe acute pancreatitis. Here, we assess the therapeutic efficacy of gradually combined treatment of parenteral nutrition (PN) with enteral nutrition (EN) for SAP. Methods. The clinical data of 130 cases of SAP were analyzed retrospectively. Of them, 59 cases were treated by general method of nutritional support (Group I) and the other 71 cases were treated by PN gradually combined with EN (Group II). Results. The APACHE II score and the level of IL-6 in Group II were significantly lower than Group I (P < 0.05). Complications, mortality, mean hospital stay, and the cost of hospitalization in Group II were 39.4 percent, 12.7 percent, 32 ± 9 days, and 30869.4 ± 12794.6 Chinese Yuan, respectively, which were significantly lower than those in Group I. The cure rate of Group II was 81.7 percent which is obviously higher than that of 59.3% in Group I (P < 0.05). Conclusions. This study indicates that the combination of PN with EN not only can improve the natural history of pancreatitis but also can reduce the incidence of complication and mortality.
背景与目的。在重症急性胰腺炎（SAP）的治疗中，肠内营养与肠外营养在营养支持方面存在争议。在此，我们评估肠外营养（PN）与肠内营养（EN）逐步联合治疗SAP的疗效。方法。回顾性分析130例SAP患者的临床资料。其中，59例采用常规营养支持方法治疗（I组），另外71例采用PN逐步联合EN治疗（II组）。结果。II组的急性生理与慢性健康状况评分系统II（APACHE II）评分和白细胞介素-6（IL-6）水平显著低于I组（P < 0.05）。II组的并发症发生率、死亡率、平均住院天数和住院费用分别为39.4%、12.7%、32±9天和30869.4±12794.6元，均显著低于I组。II组的治愈率为81.7%，明显高于I组的59.3%（P < 0.05）。结论。本研究表明，PN与EN联合应用不仅可以改善胰腺炎的病程，还可以降低并发症发生率和死亡率。
