经鼻空肠营养支持在重症急性胰腺炎治疗中的疗效观察

目的研究早期经鼻空肠营养支持对重症急性胰腺炎（SAP）的治疗作用。方法回顾性分析近年来洛阳市中心医院收治的48例重症急性胰腺炎患者的临床资料，其中应用全胃肠外营养治疗25例（TPN组），应用肠内营养治疗23例（EN组）。观察两组治疗期间c-反应蛋白、血清白蛋白水平、疾病恢复及并发症出现情况，并进行统计学处理。结果治疗1周后，EN组和TPN组c一反应蛋白水平、ApacheU评分比较差异均有统计学意义。EN组和TPN组治疗第2天和第14天的血清白蛋白水平组内比较差异均有统计学意义，同时间点组间比较差异均无统计学意义。TPN组出现感染7例，腹泻6例，四肢血栓1例。EN组出现感染1例，腹泻1例。结论早期经鼻空肠营养支持对重症急性胰腺炎患者安全、可靠、有效，能改善SAP患者营养状况，促进病情恢复，减少并发症，疗效显著，无严重不艮反应。

Effect of enteral nutrition through nasogastrojejunal tube on severe acute pancreatitis

Objective To study and evaluate therapeutic response of early enteral nutrition through nasogastrojejunal tube for the treatment of patients with severe acute panereatitis （SAP）. Meth- ods The clinical datas of 48 patients with SAP in recent years were retrospectively analyzed. The thera- peutic response of 23 patients treated with naso - gastrojejunal tube enteral nutrition （EN） have been compared with that of 25 patients treated with total parenteral nutrition （TPN） in the levels of C - reactive protein and serum albumin, disease restoration and complications. Results The level of C - reactive pro- tein and Acute Physiology and Chronic Health Evaluation（APACHE） score were significantly different between the two groups one week after treatment. The level of serum albumin of patients treated with EN were higher than that of TPN the next day and 14th day, and compared with time points between groups were not statistically significant. TPN group has infection in 7 cases, diarrhea in 6 cases, limbs thrombo- sis in 1 case. EN group has infection in 1 case, diarrhea in 1 case. Conclusions Early enteral nutrition through nasogastrojejunal tube for SAP patients is safe, reliable and it can improve nutritional status, pro- mote illness recovery and reduce the complications.