摘要
目的探讨肠内、外营养支持治疗重症急性胰腺炎的临床疗效。方法将86例重症急性胰腺炎患者随机分为治疗组和对照组,每组各43例。两组均予以急性胰腺炎常规基础治疗,包括监护、禁食、胃肠减压、静脉输液补足血容量、维持水电解质和酸碱平衡、抗感染、抑酸治疗、抑制胰酶活性等。对照组给予完全胃肠外营养治疗,治疗组予以胃肠外营养联合肠内营养治疗。结果两组患者治疗后APACHEⅡ评分和Ranson评分与治疗前比较均明显改善,治疗前后比较,差异均有高度统计学意义(均P<0.01);治疗后治疗组APACHEⅡ评分为(5.82±2.05)分,Ranson评分为(2.27±0.92)分;对照组APACHEⅡ评分为(7.13±2.26)分,Ranson评分为(2.95±0.97)分,两组比较差异均有高度统计学意义(均P<0.01)。两组患者治疗后血清白蛋白和血清前白蛋白水平与治疗前比较均明显改善,治疗前后比较,差异均有高度统计学意义(均P<0.01);治疗后治疗组血清白蛋白和血清前白蛋白水平[(41.14±6.21)g/L、(284.67±90.35)mg/L]与对照组[(37.92±5.83)g/L、(237.25±84.46)mg/L]比较,差异有统计学意义(P<0.05)。治疗组并发症发生率为48.84%,对照组为67.77%,两组比较差异有统计学意义(P<0.05)。结论肠内营养与胃肠外营养联合支持能够降低重症急性胰腺炎并发症发生率,提高临床疗效,值得推广应用。
Objective To investigate the clinical efficacy of enteral and parenteral nutrition support in the treatment of patients with severe acute pancreatitis.Methods 86 patients with severe acute pancreatitis were randomly divided into treatment group and control group,each group had 43 cases.All patients were treated with conventional treatment,monitoring,fasting,gastrointestinal decompression,venous transfusion,balance of water,electrolyte and acid-base,antiinfection,acid suppression therapy,suppression of trypsin activity were included.Control group were treated with total parenteral nutrition.Treatment group were received parenteral nutrition combined with enteral nutrition therapy.Results After treatment,the APACHE Ⅱ score and Ranson score of the two groups were all improved than that of before treatment,the differences were statistically significant（all P 0.01）.After treatment the APACHE Ⅱ score of treatment group was（5.82±2.05） points and the Ranson score was（2.27±0.92） points;the APACHE Ⅱ score of the control group was（7.13±2.26） points and the Ranson score was（2.95±0.97） points,the differences were statistically significant（all P 0.01）.After treatment,serum albumin and prealbumin levels of the two groups were significantly improved than those before treatment,the differences were statistically significant（all P 0.01）.After treatment serum albumin and serum prealbumin levels were compared between treatment group and control group [（41.14±6.21） g/L,（284.67±90.35） mg/L vs（37.92±5.83） g/L,（237.25±84.46） mg/L],the differences were statistically significant（P 0.05）.The complication rate was 48.84% in the treatment group,which was 67.77% in the control group,compared the complications incidence of the two groups,the difference was significant（P 0.05）.Conclusion Enteral nutrition combined with parenteral nutrition support can reduce the incidence of complications and improve the clinical efficacy of severe acute pancreatitis.It is worthy of widely application.
出处
《中国医药导报》
CAS
2012年第3期71-72,92,共3页
China Medical Herald
关键词
重症急性胰腺炎
胃肠外营养
肠内营养
Severe acute pancreatitis
Parenteral nutrition
Enteral nutrition
