摘要
目的探讨早期肠内营养(EN)治疗在重症急性胰腺炎综合治疗中的价值。方法 42例患者按随机数字表法分为EN组21例和对照组21例,2组基线资料匹配。EN组在对照组常规治疗基础上,在胃肠功能恢复时尽快启用EN,观察各项指标变化情况及感染率、病死率、并发症发生率、住院时间和总住院费用。结果入院当日,2组C反应蛋白(CRP)、血清淀粉酶(AMY)、血浆白蛋白水平和APACHEII评分差异无统计学意义(P均>0.05);治疗2周上述各项指标对比,EN组均优于对照组(P<0.01,P<0.05);EN组治疗后感染率(33.33%vs66.67%,P<0.05)、并发症总发生率(28.57%vs71.43%,P<0.01)、住院天数〔(20.50±2.70)vs(26.21±3.11)d,P<0.01〕及住院费用〔(4.20±1.20)vs(6.51±1.60)万元,P<0.01〕均明显低于对照组;EN组病死率稍低于对照组,但差异无统计学意义(P>0.05)。结论肠道功能恢复期尽早行EN有利于维护肠屏障功能、降低胰腺炎并发症发生率、提高治愈率。
Objective To assess the therapeutic effect of early enteral nutrition （EN） in the synthetical treatment of severe acute pancreatitis （SAP）. Methods Forty-two patients with SAP were randomly divided into basic data-matched EN group and control group （n=21 each）.The conventional treatment was given in control group.On top of the conventional treatment,EN therapy was started as soon as possible based on recovery of gastrointestinal function in the EN group.The changes of some indicators including C-reactive protein（CRP）,serum amylase, plasma albumin and APACHEⅡscore,infection rate, fatality rate,incidence of complications,the hospital stays and total costs were observed and compared between the two groups. Results Compared with the control group,The levels of CRP,serum amylase, plasma albumin and APACHEⅡscore were all improved（P〈0.05 or P〈0.01）after treatment of 2 weeks in the EN group . The infection rate（33.33% vs 66.67%,P〈0.05）,the incidence of complications（28.57% vs 71.43%,P〈0.01）,the hospital stays 〔（20.50±2.70） vs （26.21± 3.11） d, P〈0.01〕 and the total costs 〔（4.20±1.20） vs （6.51±1.60）×10^4 yuan,P〈0.01〕 were all significantly lower in EN group than those in control group.The fatality rate was slightly lower in EN group than that in control group,but there was no statistical significance between them（P〈0.05）. Conclusions EN treatment as early as possible in the recovery stage is helpful in maintaining the intestinal barrier function, reducing complications and raising cure rate in patients with SAP.
出处
《中国临床研究》
CAS
2012年第4期322-323,共2页
Chinese Journal of Clinical Research
基金
汕头市科技计划社会发展攻关项目(汕府科〔2011〕46号)
关键词
重症急性胰腺炎
肠内营养
早期
治疗
Severe acute pancreatitis
Enteral nutrition
early
Therapy
