早期肠内营养在重症急性胰腺炎治疗中的疗效评价(1)
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[摘要] 目的：探讨早期空肠内营养支持疗法在重症急性胰腺炎(SAP)治疗中应用的安全性和有效性。方法：采用回顾性方法分析我院2007年1月~2010年12月收治的52例SAP患者的临床资料，按营养支持不同分为肠内营养(EN)组和全胃肠外营养(TPN)组，每组各26例，观察两组治疗前后各生化指标、APACHE-Ⅱ评分、住院天数、平均住院费用、并发症发生率和死亡率的差异。结果：EN组治疗2周后C反应蛋白和APACHE-Ⅱ评分明显低于TPN组，而血清白蛋白和前白蛋白水平明显高于TPN组，差异均有统计学意义(P<0.05)；EN组患者的住院天数和平均住院费用均明显低于TPN组(P<0.05)，而两组患者的并发症发生率和死亡率差异无统计学意义(P>0.05)。结论：早期肠内营养对SAP的治疗是安全、有效的，有助于改善SAP患者的营养状况，值得临床进一步推广。
[关键词] 重症急性胰腺炎；肠内营养；全胃肠外营养
[中图分类号] R657.51 [文献标识码] A [文章编号] 1673-7210(2011)12(a)-050-03
Clinical evaluation of early enteral nutrition in the treatment of severe acute pancreatitis
XIA Yuehua
Department of Emergency Medicine, the People's Hospital of Rugao City, Jiangsu Province, Rugao 226500, China
[Abstract] Objective: To discuss the safety and efficacy of early enteral nutrition (EN) in the treatment of severe acute pancreatitis (SAP). Methods: 52 cases of patients who were diagnosed with SAP in our hospital from January 2007 to December 2010 were analyzed retrospectively. All patients were divided into EN group and total parenteral nutrition (TPN) group, each group had 26 cases. Biochemical indexes, APACHE-Ⅱscores, length of stay, incidence of complications, mortality, and hospital expenses were compared between the two groups before and after treatment. Results: Blood C-reactive protein level and APACHE-Ⅱscores were significantly lower of EN group than those of TPN group after 2 weeks' treatment (P<0.05), while serum prealbumin and albumin levels of EN group were significantly higher than those of TPN group, the differences were statistically significant (P<0.05). The length of stay and hospital expenses of EN group were significantly shorter and lower than those of TPN group (P<0.05), and the mortality and incidence of serious complications were compared between the two groups, the differences were not statistically significant (P>0.05). Conclusion: Early EN is a safe and effective method in the treatment of SAP, which is helpful to improve the nutrition status of SAP patients ......
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