摘要
目的：探讨改善重症胰腺炎术后患者的早期营养状况和预后措施。方法将2012年4月—2014年4月56例重症胰腺炎术后患者按术后场内营养时间点不同分为观察组与对照组各28例。两组均给予常规治疗,术后第1天经周围静脉给予肠外营养,观察组于术后第3天行肠内营养,对照组于术后第7天行肠内营养,比较两组患者行肠内营养后前白蛋白、白蛋白、氮平衡及感染率情况。结果本组56例患者术后均恢复良好,无死亡、感染发生；术后第3天两组患者前白蛋白、白蛋白及氮平衡值比较差异无统计学意义（P〉0.05）；术后第10天观察组患者前白蛋白、白蛋白及氮平衡值分别为（320.41±12.3）mg/L、（39.26±6.25）g/L、（0.65±0.31）%,均优于对照组,差异有统计学意义（t值分别为5.7394,5.9017,1.9079；P〈0.05）。两组患者对早期肠内营养的耐受性比较差异无统计学意义（P〉0.05）。结论综合耐受性及预后情况,最佳的肠内营养时机约为术后5d。在患者可耐受的情况下尽早实施,可有效降低感染率及并发症发生。
Objective To improve the nutritional status and prognosis of postoperative patients with severe acute pancreatitis. Methods A total of 56 patients with severe acute pancreatitis were randomly divided into the observation group （ n =28 ） and control group （ n =28 ） from April 2012 to April 2014. On the basis of the conventional parenteral vien nutrition, enteral nutrition was applied respectively on the third day after surgery in observation group and on the seventh day after surgery in control group, respectively. The levels of prealbumin, albumin, the percentage of Nitrogen balance and infection rate of the two groups were compared. Results All the 56 patients recovered well postoperatively, with no death or infection. Three days after the surgery, patients′nutritional indicators had no statistically significant difference （P〉0. 05）. Ten days after the surgery, prealbumin, albumin and Nitrogen balance values in the observation group were （320.41 ±12.3）mg/L, （39.26 ±6.25）g/L and （0. 65 ± 0. 31）%, respectively, which were significantly better than those in the control group （t=5. 739 4, 5. 901 7, 1. 907 9, respectively;P〈0. 05）. The tolerance of early enteral nutrition comparison showed that there was no statistically significant difference between the two groups （ P 〉 0. 05 ）. Conclusions Concerning the tolerance and prognosis, the best time for applying enteral nutrition is about five days after surgery. If patients can be tolerated, the early enteral nutrition can effectively reduce the infection rate and complications.
出处
《中华现代护理杂志》
2015年第7期822-824,共3页
Chinese Journal of Modern Nursing
关键词
胰腺炎
急性坏死性
手术后并发症
肠内营养
Severe acute pancreatitis
Postoperative complications
Enteral nutrition
