胃肠外营养(PN)支持治疗急性重症胰腺炎27例报告
作者：王严庆 张军
单位：重庆医科大学附属第一医院胃肠外科
关键词：
中国临床营养杂志000146摘 要：目的总结1987年5月～1999年4月我院27例急性重症胰腺炎患者，应用胃肠外营养(PN)支持治疗的经验。 方法患者病情大多重危，病程长，平均64天，最长179天，并发症多，代谢紊乱和营养不良问题突出。PN支持平均24天，最长72天，多数从病程早期开始，覆盖整个消化道功能障碍时期，直到恢复进食。综合治疗十分重要，本组包括：早期1周内手术17例，9、10天手术各1例，术中或(和)术后胰床和腹腔灌洗13例，以及内科治疗措施，后期胰腺脓肿引流及坏死组织清除7例。 结果22例治愈(81.5%)，死亡5例(18.5%)。死因为胰腺脓毒症并发感染性休克3例，衰竭合并肺部感染而发生多脏器功能不全2例，均系后期死亡。 结论TPN能满足高代谢状态下营养需求、纠正代谢紊乱，促使消化道及其腺体处于休息状态，是急性重症胰腺炎的基本治疗措施。
Parenteral nutrition in acute severe pancreatitis-report of 27 cases
WANG Yanqing ,ZHANG Jun
(Department of Gostrointestinal Surgery, The First Affiliated Hopsital of Chongqin Medical University)
Abstract：Abstracts Experience in total parenteral nutrition (TPN) support for 27 patients with acute severe panereatitis is presented. Most patients were seriously ill, and the course were long and complicated with a mean duration of 64 days, and the longest one was 179 days. Metabolic disturbance and malnutrition were very conspicuous. The mean duration of TPN support for each patient was 24 days, and the longest one maintained for 72 days. TPN began from the early stage and cover the whole period of alimentary dysfunction until the patient could take food by mouth in most patients. Combined treatment was important, ineluding: early operation in 19 patients, intra-and/or postoperative lavage of pancreatic bed and and peritoneal cavity in 13 patients, and as well as appropriated conservative management. Late operative drainage for pancreatic abscess was done in 7 cases. Results Were satisfactory with 22 (81. 5% ) were cured and 5 (18. 5% ) died. In the latter, 3 were died of pancreatic sepsis complicated with infective shock, 2 died of exhaustion, together with pneumonia and multiple system organ filure. None of early died., 百拇医药
单位：重庆医科大学附属第一医院胃肠外科
关键词：
中国临床营养杂志000146摘 要：目的总结1987年5月～1999年4月我院27例急性重症胰腺炎患者，应用胃肠外营养(PN)支持治疗的经验。 方法患者病情大多重危，病程长，平均64天，最长179天，并发症多，代谢紊乱和营养不良问题突出。PN支持平均24天，最长72天，多数从病程早期开始，覆盖整个消化道功能障碍时期，直到恢复进食。综合治疗十分重要，本组包括：早期1周内手术17例，9、10天手术各1例，术中或(和)术后胰床和腹腔灌洗13例，以及内科治疗措施，后期胰腺脓肿引流及坏死组织清除7例。 结果22例治愈(81.5%)，死亡5例(18.5%)。死因为胰腺脓毒症并发感染性休克3例，衰竭合并肺部感染而发生多脏器功能不全2例，均系后期死亡。 结论TPN能满足高代谢状态下营养需求、纠正代谢紊乱，促使消化道及其腺体处于休息状态，是急性重症胰腺炎的基本治疗措施。
Parenteral nutrition in acute severe pancreatitis-report of 27 cases
WANG Yanqing ,ZHANG Jun
(Department of Gostrointestinal Surgery, The First Affiliated Hopsital of Chongqin Medical University)
Abstract：Abstracts Experience in total parenteral nutrition (TPN) support for 27 patients with acute severe panereatitis is presented. Most patients were seriously ill, and the course were long and complicated with a mean duration of 64 days, and the longest one was 179 days. Metabolic disturbance and malnutrition were very conspicuous. The mean duration of TPN support for each patient was 24 days, and the longest one maintained for 72 days. TPN began from the early stage and cover the whole period of alimentary dysfunction until the patient could take food by mouth in most patients. Combined treatment was important, ineluding: early operation in 19 patients, intra-and/or postoperative lavage of pancreatic bed and and peritoneal cavity in 13 patients, and as well as appropriated conservative management. Late operative drainage for pancreatic abscess was done in 7 cases. Results Were satisfactory with 22 (81. 5% ) were cured and 5 (18. 5% ) died. In the latter, 3 were died of pancreatic sepsis complicated with infective shock, 2 died of exhaustion, together with pneumonia and multiple system organ filure. None of early died., 百拇医药