CAJ | 학술논문

目的：观察早期肠内营养治疗重症急性胰腺炎(SAP)的安全性和疗效。方法：2008年1月-2014年1月6年期间收治的82例SAP患者按营养方式不同分为两组，每组41例，采用早期肠内营养治疗为EN组（即入院第3 d置入空肠营养管）；采用肠外营养治疗为PN组；比较2组患者的治疗效果、营养状况的改变以及住院费用，同时比较两组患者入院第3 d和第7 d血浆内毒素水平的变化以及血TNF-α变化。结果： EN组入院第7 d血浆内毒素水平及血TNF-α下降明显。PN组营养支持时间、住院天数、平均住院费用均高于EN组（P＜0.05）。结论：早期肠内营养治疗SAP能改善营养、维护肠道黏膜屏障、减轻炎症反应以及降低住院费用等。
목적：관찰조기장내영양치료중증급성이선염(SAP)적안전성화료효。방법：2008년1월-2014년1월6년기간수치적82례SAP환자안영양방식불동분위량조，매조41례，채용조기장내영양치료위EN조（즉입원제3 d치입공장영양관）；채용장외영양치료위PN조；비교2조환자적치료효과、영양상황적개변이급주원비용，동시비교량조환자입원제3 d화제7 d혈장내독소수평적변화이급혈TNF-α변화。결과： EN조입원제7 d혈장내독소수평급혈TNF-α하강명현。PN조영양지지시간、주원천수、평균주원비용균고우EN조（P＜0.05）。결론：조기장내영양치료SAP능개선영양、유호장도점막병장、감경염증반응이급강저주원비용등。
Objective To observe the safety and effectiveness of early treatment of enteral nutrition in pa-tients with severe acute pancreatitis (SAP). Methods During the last 6 years from January 2008 to January 2014,82 patients with SAP were divided into two groups on the basis of various nutrition support. 41 cases were in early enteral nutrition treatment group (EN group) and the other 41 cases belonged to parenteral nutrition treatment group (PN group). Effectiveness, changes in nutritional status, cost of hospitalization, the trend of plas-ma endotoxin level and TNF-α in blood before and after the implantation of Jejunum nutrition tube were com-pared between the two groups. Results The abdominal perimeter and abdominal pressure were decreased obvi-ously in both of the treatment groups. But exhaust and defecation shorten time significantly in EN group than PN group. Comparing with PN group, plasma endotoxin level and TNF-α in blood of EN group reduced greatly after the implantation of Jejunum nutrition tube. Nutrition support time, hospital stay and cost of hospitalization in PN group were significantly higher than that in EN group (P<0.05). Conclusion Treatment with early enteral nutrition in SAP has advantages in improving body nutritional condition,maintaining intestinal mucosal barrier, alleviating inflammatory reaction in acute phase of acute pancreatitis and reducing medical expenditure.