中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
2期
166-168
,共3页
任俊%余开焕%马鹏%陈辰
任俊%餘開煥%馬鵬%陳辰
임준%여개환%마붕%진신
重症胰腺炎%早期肠内营养%肠外营养
重癥胰腺炎%早期腸內營養%腸外營養
중증이선염%조기장내영양%장외영양
Severe acute pancreatitis%Early enteral nutrition%Parenteral nutrition
目的 探讨早期肠内营养对重症急性胰腺炎(SAP)患者的疗效的影响.方法 收集58例SAP患者的病历资料进行回顾性分析,根据营养支持治疗方式分为早期肠内营养(EEN)组和阶段性肠外营养(TPN组),比较2组患者营养支持治疗第2周末的血红蛋白、空腹血糖等生化指标水平,第1、7天APACHEⅡ评分和C反应蛋白(CRP)水平,以及胃肠道功能恢复时间、并发症发生率、住院时间、住院费用和病死率.结果 治疗第2周末EEN组和TPN组患者血红蛋白、空腹血糖水平差异有统计学意义[(110±5)g/L比(102±18) g/L,(6.0±1.8) mmol/L比(9.2±3.6)mmo]/L,均P＜0.05]；血钙、淋巴细胞计数、血Cr、胆固醇及血淀粉酶水平比较,差异均无统计学意义；治疗第7天时EEN组和TPN组CRP及APACHE-Ⅱ评分差异有统计学意义[ (75 ±30) mg/L比(120±33) mg/L,(7.8±1.7)分比(9.5±2.9)分,均P＜0.05].早期组胃肠道功能恢复较早,且并发症、感染率、住院时间和费用低于阶段性组(P＜0.05),2组病死率差异无统计学意义.结论 在SAP的治疗中,早期肠内营养支持治疗能缩短病程,减少并发症,改善患者预后.
目的 探討早期腸內營養對重癥急性胰腺炎(SAP)患者的療效的影響.方法 收集58例SAP患者的病歷資料進行迴顧性分析,根據營養支持治療方式分為早期腸內營養(EEN)組和階段性腸外營養(TPN組),比較2組患者營養支持治療第2週末的血紅蛋白、空腹血糖等生化指標水平,第1、7天APACHEⅡ評分和C反應蛋白(CRP)水平,以及胃腸道功能恢複時間、併髮癥髮生率、住院時間、住院費用和病死率.結果 治療第2週末EEN組和TPN組患者血紅蛋白、空腹血糖水平差異有統計學意義[(110±5)g/L比(102±18) g/L,(6.0±1.8) mmol/L比(9.2±3.6)mmo]/L,均P＜0.05]；血鈣、淋巴細胞計數、血Cr、膽固醇及血澱粉酶水平比較,差異均無統計學意義；治療第7天時EEN組和TPN組CRP及APACHE-Ⅱ評分差異有統計學意義[ (75 ±30) mg/L比(120±33) mg/L,(7.8±1.7)分比(9.5±2.9)分,均P＜0.05].早期組胃腸道功能恢複較早,且併髮癥、感染率、住院時間和費用低于階段性組(P＜0.05),2組病死率差異無統計學意義.結論 在SAP的治療中,早期腸內營養支持治療能縮短病程,減少併髮癥,改善患者預後.
목적 탐토조기장내영양대중증급성이선염(SAP)환자적료효적영향.방법 수집58례SAP환자적병력자료진행회고성분석,근거영양지지치료방식분위조기장내영양(EEN)조화계단성장외영양(TPN조),비교2조환자영양지지치료제2주말적혈홍단백、공복혈당등생화지표수평,제1、7천APACHEⅡ평분화C반응단백(CRP)수평,이급위장도공능회복시간、병발증발생솔、주원시간、주원비용화병사솔.결과 치료제2주말EEN조화TPN조환자혈홍단백、공복혈당수평차이유통계학의의[(110±5)g/L비(102±18) g/L,(6.0±1.8) mmol/L비(9.2±3.6)mmo]/L,균P＜0.05]；혈개、림파세포계수、혈Cr、담고순급혈정분매수평비교,차이균무통계학의의；치료제7천시EEN조화TPN조CRP급APACHE-Ⅱ평분차이유통계학의의[ (75 ±30) mg/L비(120±33) mg/L,(7.8±1.7)분비(9.5±2.9)분,균P＜0.05].조기조위장도공능회복교조,차병발증、감염솔、주원시간화비용저우계단성조(P＜0.05),2조병사솔차이무통계학의의.결론 재SAP적치료중,조기장내영양지지치료능축단병정,감소병발증,개선환자예후.
Objective To explore therapeutic efficacy of early enteral nutrition (EEN) for severe acute pancreatitis (SAP).Methods Fifty-eight patients with SAP were divided into the early group (30 cases) and stage group (28 cases).Both groups had early enteral nutrition or initial parenteral nutrition support treatment respectively.The hemoglobin level,fasting blood glucose level and other indicators,the score of APACHE-Ⅱ and the level of serum CRP in different time,the change of intestines and stomach function,the incidence of complication,the infection rate,the length of stay in hospital,inpatient expenditure and death rate were compared between the two groups.Results There were significant differences in hemoglobin level and fasting blood glucose level [ ( 110 ± 5 ) g/L vs ( 102 ± 18) g/L,( 6.0 ± 1.8 ) mmol/L vs ( 9.2 ± 3.6 ) mmol/L,P ＜ 0.05 ],but no differences of serum calcium,lymphocyte count,serum creatinine,serum cholesterol and amylase level were observed.Patients treated with EEN had an early recovery of intestines and stomach function.There were significant differences in APACHE- Ⅱ score,serum CRP,complications,infection rate and hospitalized days.Inpatient expenditure was lower than that with stage nutrition support (P ＜ 0.05).The rate of death had no differences between two groups.Conclusion Patients with SAP treated with EEN can decrease the length of stay in hospital with optimal therapy outcomes.
