重症急性胰腺炎患者营养支持方式的偏好比较

Comparison of the Preference of Nutritional Support for Patients With Severe Acute Pancreatitis.

作者信息

Hui Liangliang, Zang Kui, Wang Min, Shang Futai, Zhang Guoxin

机构信息

Liangliang Hui, MD, is Physician, Department of ICU, the First People's Hospital of Huaian, Nanjing Medical University, Jiangsu, China. Kui Zang, MD, is Physician, Department of ICU, the First People's Hospital of Huaian, Nanjing Medical University, Jiangsu, China. Min Wang, MD, is Physician, Department of ICU, the First People's Hospital of Huaian, Nanjing Medical University, Jiangsu, China. Futai Shang, MD, is Physician, Department of ICU, the First People's Hospital of Huaian, Nanjing Medical University, Jiangsu, China. Guoxin Zhang, MD, is Physician, Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical, University, Jiangsu, China.

出版信息

Gastroenterol Nurs. 2019 Sep/Oct;42(5):411-416. doi: 10.1097/SGA.0000000000000331.

DOI:10.1097/SGA.0000000000000331

PMID:31246632

Abstract

This study aimed to compare the preference of different methods of nutritional support for patients with severe acute pancreatitis (SAP). Patients with SAP were divided into the enteral nutrition group (EN group, 16 cases), total the parenteral nutrition group (TPN group, 14 cases), and the enteral plus total parenteral nutrition group (EN+TPN group, 15 cases). At 7 days after admisson, TPN and EN+TPN groups showed significantly increased Ranson scores compared with the EN group (p < .05). At 14 and 21 days after admisson, TPN and EN+TPN groups exhibited significantly increased Acute Physology and Chronic Health Evaluation (APACHE) II scores, Ranson scores, and intra-abdominal pressure compared with the EN group (p < .05 or p < .01). The incidences of multiple organ dysfunction syndrome and its complication in the EN group were significantly lower than the TPN and EN+TPN groups (p < .05). Hospital stay was significantly lower, but the incidences of abdominal distenson and regurgitation complications were significantly higher in the EN group than in the TPN and EN+TPN groups (p < .05). In concluson, early enteral nutrition could significantly improve nutritional status of patients with SAP, shorten the course of the disease, and reduce the incidences of infection, death, and complication, but also increase the risk of abdominal distenson and regurgitation.

摘要

本研究旨在比较不同营养支持方法对重症急性胰腺炎（SAP）患者的适用性。将SAP患者分为肠内营养组（EN组，16例）、全肠外营养组（TPN组，14例）和肠内加全肠外营养组（EN + TPN组，15例）。入院7天时，TPN组和EN + TPN组的Ranson评分与EN组相比显著升高（p < 0.05）。入院14天和21天时，TPN组和EN + TPN组的急性生理与慢性健康状况评分系统（APACHE）II评分、Ranson评分和腹内压与EN组相比显著升高（p < 0.05或p < 0.01）。EN组多器官功能障碍综合征及其并发症的发生率显著低于TPN组和EN + TPN组（p < 0.05）。EN组的住院时间显著缩短，但腹胀和反流并发症的发生率显著高于TPN组和EN + TPN组（p < 0.05）。总之，早期肠内营养可显著改善SAP患者的营养状况，缩短病程，降低感染、死亡及并发症的发生率，但也会增加腹胀和反流的风险。