【摘要】 目的:探讨不同的鼻饲营养途径对重症急性胰腺炎(SAP)病人疾病发展状况的影响。方法:选择27例连续禁食48 h以上,且胃肠功能恢复、腹痛已缓解的SAP病人,随机分成两组,分别行鼻胃管鼻饲营养(14例)和鼻空肠管鼻饲营养(13例)。记录血清淀粉酶、脂肪酶、C反应蛋白(CRP)和Balthazar CT评分,分析腹痛再发例次和病程进展状况。结果:鼻胃管鼻饲组和鼻空肠管鼻饲组中分别有8例(57.1%)和2例(15.4%)发生腹痛再发(P<0.05),鼻胃管组和腹痛再发者的总住院时间、鼻饲后住院时间均分别较鼻空肠管组和无腹痛者长(P<0.05,P<0.01)。血淀粉酶、脂肪酶、CRP恢复正常的时间亦较长(P<0.05,P<0.01)。鼻胃管组有4例(28.6%)须停止鼻饲,有2例(14.3%)死亡,而鼻空肠管组则均无上述情况发生率。发生腹痛者的患病在第21天的Balthazar’s CT评分较高。结论:鼻空肠管鼻饲营养较鼻胃管鼻饲营养者能显著减少SAP的腹痛再发和缩短疾病治疗时间。更多还原

【Abstract】 Objective: To investigate the effects of different enteral feeding route through nose on severe acute pancreatitis.Methods: A total of 27 patients with SAP were randomized to feeding by either nasogastric(NG) route(14 patients) or nasojejunal(NJ) route(13 patients).All the patients were treated with 48h fasting,and had restored gastro-intestinal function and felt bellyache mitigative.The level of clinical and biochemical index(amylase,lipase and C-reaction protein in blood serum) and Balthazar CT score were recorded.The number of patients with recurrence of bellyache and the change of diseases were analyzed.Results: 8(57.1%)patients in NG group and 2(15.4%)patients in NJ group had recurrence of bellyache(P<0.05).The durations of total staying in hospital and staying in hospital after nasal feeding in NG group and patients with recurrent abdominal pain were significantly longer than those in NJ group and in patients without recurrent abdominal pain.The days for restoring normal level of amylase,lipase and C-reaction protein in blood serum was also longer in NJ group and in patients with recurrent abdominal pain compared with those in NJ group and in patients without recurrent abdominal pain.4 patients in NG group had to stop nasal feeding,and 2 of them died.But these didn’t happen in NJ group.CT score of the patients with recurrent abdominal pain on 21th day was higher than that of the patients without recurrent abdominal pain.Conclusion: Enteral feeding with NJ route can significantly decrease the recurrence of bellyache and shorten the duration of treatment compared with NG route in SAP patients.更多还原