[1]韩晓红,田　静,万　强,等.肠内营养支持和全胃肠外营养支持治疗急性胰腺炎疗效比较[J].新乡医学院学报,2018,35(10):910-913.[doi:10.7683/xxyxyxb.2018.10.015]
　HAN Xiao-hong,TIAN Jing,WAN Qiang,et al.Comparison of efficacy between enteral nutrition support and total parenteral nutrition support in the treatment of acute pancreatitis[J].Journal of Xinxiang Medical University,2018,35(10):910-913.[doi:10.7683/xxyxyxb.2018.10.015]
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肠内营养支持和全胃肠外营养支持治疗急性胰腺炎疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年10
页码:
910-913
栏目:
临床研究
出版日期:
2018-10-05

文章信息/Info

Title:
Comparison of efficacy between enteral nutrition support and total parenteral nutrition support in the treatment of acute pancreatitis
作者:
韩晓红; 田　静; 万　强; 马明阳; 姜传斌
（新乡医学院第三附属医院急诊科，河南　新乡　453003）
Author(s):
HAN Xiao-hong; TIAN Jing; WAN Qiang; MA Ming-yang; JIANG Chuan-bin
（Department of Emergency，the Third Affiliated Hospital of Xinxiang Medical University，Xinxiang 453003，Henan Province,China）
关键词:
急性胰腺炎; 肠内营养; 全胃肠外营养
Keywords:
acute pancreatitis; enteral nutrition support; total parenteral nutrition support
分类号:
R657.5+1
DOI:
10.7683/xxyxyxb.2018.10.015
文献标志码:
A
摘要:
目的　比较肠内营养支持和全胃肠外营养支持治疗急性胰腺炎的临床疗效。方法　将新乡医学院第三附属医院2016年1月至2017年2月收治的56例急性胰腺炎患者分为观察组和对照组，每组28例。2组患者入院后均给予肠胃气体及液体排出、卧床休息、严格禁食水、胃肠减压等常规治疗措施。在此治疗基础上，对照组患者给予肠内营养支持治疗，观察组患者给予全胃肠外营养支持治疗，2组患者均治疗2周。比较治疗前后2组患者血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）水平、白细胞计数（WBC）及CT评分、急性生理与慢性健康评分（APACHEⅡ），并比较2组患者并发症发生率、治疗费用及住院时间。结果　治疗前2组患者血清IL-6、TNF-α、CRP水平及WBC比较差异无统计学意义（P>0.05）。治疗后2组患者血清IL-6、TNF-α、CRP水平及WBC低于治疗前（P<0.05）。治疗后2组患者血清IL-6、TNF-α水平比较差异无统计学意义（P>0.05）；观察组患者WBC、CRP水平低于对照组（P<0.05）。治疗前2组患者CT评分和APACHEⅡ评分比较差异无统计学意义（P>0.05）。治疗后2组患者CT评分和APACHEⅡ评分低于治疗前（P<0.05），且观察组患者CT评分和APACHEⅡ评分低于对照组（P<0.05）。观察组患者腹痛、发热、休克、恶心呕吐、腹胀发生率均低于对照组（χ2=6.693、11.633、8.672、7.109、9.375，P<0.05）。与对照组比较，观察组患者治疗费用低（P<0.05），住院时间短（P<0.05）。结论　与肠内营养支持比较，全胃肠外营养支持治疗急性胰腺炎可减轻患者炎症反应，且具有并发症发生率低、住院费用少、住院时间短等优点。
Abstract:
Objective　To compare the clinical efficacy of enteral nutrition support and total parenteral nutrition support in the treatment of acute pancreatitis.Methods　Fifty-six patients with acute pancreatitis who were treated in the Third Affiliated Hospital of Xinxiang Medical University from January 2016 to February 2017 were divided into observation group and control group，with 28 cases in each group.After admission，patients in the two groups were given routine treatment measures such as gastrointestinal gas and liquid discharge，bed rest，strict fasting and water and gastrointestinal decompression.Based on those treatment，the patients in the control group were given enteral nutrition support，while the patients in the observation group were given total parenteral nutrition support.The serum level of interleukin-6（IL-6），tumor necrosis factor-alpha（TNF-α），C-reactive protein（CRP） and white blood cell（WBC） and CT scores，acute physiology and chronic health evaluation Ⅱ（APACHEⅡ） scores were compared between the two groups before and after treatment，and the complication rate，treatment cost and length of stay were compared between the two groups.Results　There was no significant difference in the levels of IL-6，TNF-α，CRP and WBC between the two groups before treatment（P>0.05）.After treatment the levels of IL-6，TNF-α，CRP and WBC in the two groups were significantly lower than those before treatment（P<0.05）.There was no significant difference in the levels of IL-6 and TNF-α in the two groups after treatment（P>0.05）.The levels of WBC and CRP in the observation group were significantly lower than that in the control group（P<0.05）.There was no significant difference in the CT scores and APACHEⅡscores between the two groups before treatment（P>0.05）.After treatment the CT scores and APACHEⅡscores in the two groups were lower than those before treatment（P<0.05）；the CT scores and APACHEⅡscores in the observation group were significantly lower than those in the control group（P<0.05）.The incidence of abdominal pain，fever，shock，nausea and vomiting and abdominal distension in the observation group were lower than those in the control group（χ2=6.693，11.633，8.672，7.109，9.375；P<0.05）.Compared with the control group，in the observation group the treatment cost was lower and length of stay was shorter（P<0.05）.Conclusion　Comparing with enteral nutrition support，the total parenteral nutrition support for treating acute pancreatitis has the advantage of low complication rate，few treatment cost and short length of stay.

参考文献/References:

［1］　夏芝辉，闫智杰，韩飚，等.早期肠内外营养支持治疗重症急性胰腺炎的效果观察［J］.临床合理用药杂志，2015，14（32）：115-116.
［2］　牛延军，王玮璟，曾高云，等.46例重症急性胰腺炎营养支持治疗的效果观察［J］.医药前沿，2017，7（18）：116-117.
［3］　苏炳洪，刘丽.肠内营养支持治疗重症急性胰腺炎临床效果观察［J］.中国医药导报，2008，5（35）：35-36.
［4］　冯仕彦，胡卫建.全身炎性反应综合征与Balthazar-CTSI评分对急性胰腺炎预后评估的影响［J］.临床合理用药杂志，2011，4（21）：27-28.
［5］　韩莉，康焰.急性生理功能和慢性健康状况评分系统Ⅱ和Ⅳ对192例重度急性胰腺炎死亡风险预测的比较［J］.中华消化杂志，2016，36（3）：177-179.
［6］　梁紫恩，韩莉，韦宏成，等.通腑泄热中药治疗急性胰腺炎的系统评价［J］.世界中医药，2018，13（7）：1799-1803.
［7］　姚红兵，曾荣城，文明波，等.早期肠内营养与延迟肠内营养治疗重症急性胰腺炎的临床疗效比较［J］.实用医学杂志，2014，30（14）：2231-2233.
［8］　刁艳青，汪志明，王震龙，等.经皮内镜下胃/空肠造口置管术在重症急性胰腺炎病人肠内营养治疗中的应用［J］.肠外与肠内营养，2014，21（5）：309-310.
［9］　陈凌云，蔡东联，林健，等.复合乳酸菌对不同营养治疗途径的重症急性胰腺炎大鼠肠屏障功能的影响［J］.世界华人消化杂志，2015，15（10）：1073-1081.
［10］　周瑞祥.谷氨酰胺强化早期肠内营养治疗重症急性胰腺炎的临床观察［J］.医药导报，2014，32（7）：885-889.

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更新日期/Last Update: 2018-10-05