钟平玉

【摘要】 目的：探討急性重症胰腺炎（SAP）患者早期肠内外营养支持的临床价值。方法：选取2017年6月-2019年6月笔者所在医院收治的SAP患者80例，将其依据随机数字表法分成对照组与观察组，每组40例。观察组行肠内营养支持（EN），对照组行肠外营养支持（PN）。比较两组支持前及支持3周后的空腹血糖、白蛋白、血红蛋白、胆固醇、血肌酐水平及住院时间、并发症发生情况和病死情况。结果：两组支持3周后营养状况均较支持前有明显改善，差异有统计学意义（P<0.05）。观察组空腹血糖下降幅度及血红蛋白升高幅度明显优于对照组，差异均有统计学意义（P<0.05）。观察组高血糖、感染、多器官功能不全发生率均明显低于对照组，差异有统计学意义（P<0.05）。观察组住院时间短于对照组，差异有统计学意义（P<0.05）。两组病死率比较差异无统计学意义（P>0.05）。结论：SAP患者给予EN，能改善其营养状况，减少并发症发生，缩短住院时间，临床应用价值突出。

【关键词】 急性重症胰腺炎 早期肠内营养支持 胃肠外营养支持

doi：10.14033/j.cnki.cfmr.2020.21.061 文献标识码 B 文章编号 1674-6805（2020）21-0-03

Clinical Value of Early Enteral and Parenteral Nutrition Support in Patients with Severe Acute Pancreatitis/ZHONG Pingyu. //Chinese and Foreign Medical Research， 2020， 18（21）： -149

[Abstract] Objective： To explore the clinical value of early enteral and parenteral nutrition support in patients with severe acute pancreatitis （SAP）. Method： A total of 80 patients with SAP admitted in our hospital from June 2017 to June 2019 were selected and divided into the control group and the observation group according to the random number table method， with 40 patients in each group. The observation group received enteral nutritional support （EN） and the control group received parenteral nutritional support （PN）. Fasting blood glucose， albumin， hemoglobin， cholesterol， serum creatinine levels， length of hospital stay， incidence of complications， and mortality were compared between the two groups before and 3 weeks after support. Result： The nutritional status of the two groups after 3 weeks of support were significantly improved compared with those before support， the difference was statistically significant （P<0.05）. The decrease of fasting blood glucose and the increase of hemoglobin in the observation group were significantly better than those in the control group， the differences were statistically significant （P<0.05）. The incidence of hyperglycemia， infection and multi-organ dysfunction in the observation group were significantly lower than those in the control group， the difference was statistically significant （P<0.05）. The length of hospital stay in the observation group was shorter than that in the control group， the difference was statistically significant （P<0.05）. There was no significant difference in mortality between the two groups （P>0.05）. Conclusion： EN for SAP patients can improve their nutritional status， reduce the incidence of complications， shorten the length of hospital stay， and has outstanding clinical application value.

[Key words] Severe acute pancreatitis Early enteral nutrition support Parenteral nutrition support

First-authors address： Longyan First Hospital Affiliated to Fujian Medical University， Longyan 364000， China

急性重症胰腺炎（SAP）实为一种全身性、急性的消耗性病症，发病急重，可引起多种局部、全身性并发症，有着比较高的病死率。有报道指出，SAP病死率为30%～50%[1]。在SAP治疗中，给予早期营养支持有着积极作用，且已得到临床实践与认可。其不仅能缩短此病病程，而且还能减少并发症，降低病死率。而经胃镜置入鼻空肠营养管，给予肠内营养支持（EN），简便且经济，安全性高，已被广泛应用在临床中。本文针对SAP患者，分别给予EN与肠外营养支持（PN），观察其应用价值，现报道如下。

1 资料与方法

1.1 一般资料

选取2017年6月-2019年6月笔者所在医院收治的SAP患者80例，均符合《急性胰腺炎诊治指南》（中华医学会外科学分会制定）中相关诊断标准[2]，年龄18～70岁。排除合并恶性肿瘤、严重心肺功能不全等基础疾病、妊娠状态、精神疾病者。……