【摘要】 目的:探讨不同营养支持治疗对重症急性胰腺炎预后的影响。方法:40例重症急性胰腺炎患者随机分为4组:对照组、治疗1组、治疗2组、治疗3组,每组10例。对照组给予以葡萄糖为底物的常规治疗;治疗1组采用全胃肠外营养(PN)支持治疗;治疗2组采用肠内营养(EN)支持治疗;治疗3组采用胃肠外营养→过度到肠内营养→肠内营养(PN→PN+EN→EN)支持治疗。观察4组患者在不同时段的血清AKP及GPT等指标、并发症发生率、感染率、住院时间及病死率情况。结果:治疗1、2、3组治疗后第10、20、30天血清白蛋白及转铁蛋白均显著高于对照组及治疗前水平(P<0.05,P<0.01);治疗2、3组治疗后第10天淋巴细胞计数与对照组及治疗1组之间差异均有统计学意义(P均<0.01);并发症发生率:治疗2、3、1组和对照组分别为40.0%(4/10)、40.0%(4/10),50.0%(5/10)、60.0%(6/10),治疗2、3组并发症发生率与治疗1组和对照组之间差异均有统计学意义(P均<0.05);感染率:治疗2、3、1组和对照组分别为30.0%(3/10)、30.0%(3/10)、40.0%(4/10)、60.0%(6/10),治疗2、3组感染率与治疗1组和对照组之间差异均有统计学意义(P均<0.05);治疗2、3组平均住院时间较治疗1组及对照组显著缩短[(33.64±21.74)d、(31.64±25.8)d vs(39.24±28.91)d、(42.31±26.31)d,P均<0.05];病死率:治疗1、2、3组和对照组分别为20.0%(2/10)、20.0%(2/10)、20.0%(2/10)、40.0%(4/10),治疗1、2、3组病死率与对照组之间差异均有统计学意义(P均<0.05)。结论:早期施用营养支持治疗安全、可靠,EN及PN→PN+EN→EN是重症急性胰腺炎患者的合理营养方式。更多还原

【Abstract】 Objective:To investigate the influence in severe acute pancreatitis by different nutrition modality.Methods:Forty cases of hospitalized severe acute pancrestits were selected and random divided into four groups: control group,therapy 1 group,therapy 2 group,and therapy 3 group,each group had 10 cases.Control group was treated with normal strategy of glucose;therapy 1 group treated with total parenteral nutrition(PN),therapy 2 group treated with enteral nutrition(EN)and therapy 3 group treated with PN→PN+EN→EN,compare the difference among different groups on serum AKP,GPT complication ratio,infection ratio,length of stay and fatality.Results:Compared with control group and stage before nutritional support of themselves respectively,serum albumin and transferrin in clinical research groups were all significantly raised(P<0.05,P<0.01);compared with group control and group therapy 1,lymphocyte count in group therapy 2 and group therapy 3 were significantly higher on day 10(P<0.01);complication ratio of group therapy 2 and group therapy 3 was 40.0%(4/10) and was significantly lower than that of group therapy 1 50.0%(5/10)and group control 60.0%(6/10),respectively(P<0.05);infection ratio of group therapy 2 and group therapy 3 was 30.0%(3/10) and was significantly lower than group therapy 1 40.0%(4/10)and group control 60.0%(6/10),respectively(P<0.05);the group therapy 2 and group therapy 3 average length of stay compared with group therapy 1 and group control,difference is significantly(P<0.05);fatality of therapy groups are 20.0%(2/10)and is significantly different from group control 40.0%(4/10),respectively(P<0.05).Conclusion:It’s safe to utilize nutritional support method strategy at early stage,EN and PN→PN+EN→EN are reasonable nutrition modality in severe acute pancreatitis case.更多还原