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目的探讨早期肠内营养对重症急性胰腺炎患者血清炎症指标和临床转归的影响。方法 72例重症急性胰腺炎患者,在入院24~48小时后随机分为早期肠内营养组(EEN组36例)和传统方法治疗组(对照组36例),行营养支持在内的综合治疗。观察两组患者症状、体征、白细胞(WBC)和血淀粉酶恢复正常的时间,同时比较两组患者间血清白蛋白、血清前白蛋白、住院时间、住院费用、急性生理与慢性健康状况评分(APACHEⅡ评分)、CT评分和胰腺及胰周感染发生率。结果 EEN组患者经早期肠内营养治疗后临床症状、体征和血清生化指标恢复正常的时间较对照组明显缩短(P<0.05);EEN组患者在治疗后血清白蛋白、前白蛋白、淀粉酶、白细胞等较对照组明显好转(P<0.05);EEN组患者的住院时间较对照组也明显缩短,住院费用较对照组降低(P<0.05);EEN组患者经治疗14天后APACHEⅡ和CT评分显著降低(P<0.05),且胰腺及胰周感染发生率明显降低(P<0.05)。结论早期肠内营养的合理应用有助于改善SAP患者的营养状况,具有良好的安全性和可行性。
Objective To investigate the effect of early enteral nutrition on serum inflammation and clinical outcome in patients with severe acute pancreatitis. Methods Seventy - two patients with severe acute pancreatitis were randomly divided into early enteral nutrition group (EEN group, 36 cases) and traditional treatment group (36 cases), with nutritional support after 24-48 hours of admission. . Symptoms, signs, white blood cells (WBC) and serum amylase returned to normal in both groups. The serum albumin, prealbumin, hospitalization time, hospitalization costs, acute physiology and chronic health status scores APACHEⅡscore), CT score and the incidence of pancreas and peripancreas infection. Results The clinical symptoms, signs and serum biochemical parameters of EEN patients returned to normal after treatment of early enteral nutrition were significantly shorter than those of the control group (P <0.05). Serum albumin, prealbumin, amylase (P <0.05). The hospitalization time of patients in EEN group was significantly shorter than that in control group, and the hospitalization cost was lower than that in control group (P <0.05). After 14 days of treatment, the scores of APACHEⅡ and CT in EEN group were significantly higher than those in control group (P <0.05), and the incidence of pancreas and peripancreas infection was significantly decreased (P <0.05). Conclusion The rational use of early enteral nutrition helps to improve the nutritional status of patients with SAP, with good safety and feasibility.