重症急性胰腺炎不同营养支持方式的护理和效果

发布时间：2018-03-30 18:24

本文选题：重症急性胰腺炎　切入点：肠内营养　出处：《肠外与肠内营养》2017年05期

【摘要】：目的 :比较肠外营养和经鼻-空肠管途径肠内营养在治疗重症急性胰腺炎病人中的应用效果,总结护理方法。方法 :将收治的85例重症急性胰腺炎病人按入院先后分为试验组和对照组。对照组病人给予常规肠外营养支持治疗及相应理,试验组病人则采用鼻-空肠管行肠内营养支持治疗,并在治疗期间给予相应的临床护理干预,就两组病人的各项临床指标进行比较分析。结果 :两组病人护理干预前的血清CRP、ALB、TP水平比较无统计学差异(P0.05);营养治疗及护理干预后,两组病人的CRP、ALB、TP水平均有改善,但试验组改善幅度明显大于对照组,组间差异有统计学意义(P0.05)。试验组病人治疗后BMI指数于对照组未见明显差异(P0.05)。同时其首次下床时间、机械通气时间、腹胀缓解时间、血淀粉酶以及尿淀粉酶恢复时间均较对照组有明显降低(P0.05)。两组病人腹胀、腹泻、恶心呕吐、上消化道出血等并发症比较,试验组均明显低于对照组(P0.05)。结论 :经鼻-空肠肠内营养支持治疗在有效纠正重症急性胰腺炎营养不良的同时,还能够对胃肠道起到保护作用,降低并发症的发生率。良好的临床护理干预能够保证肠内营养的顺利实施。
[Abstract]:Objective: to compare the effect of parenteral nutrition (PN) and enteral nutrition via naso-jejunal approach in the treatment of severe acute pancreatitis (SAP) and summarize the nursing methods.Methods: 85 patients with severe acute pancreatitis were divided into trial group and control group.The patients in the control group were treated with routine parenteral nutrition support and their corresponding management, while the patients in the test group were treated with naso-jejunal enteral nutrition support, and the corresponding clinical nursing intervention was given during the treatment.The clinical indexes of the two groups were compared and analyzed.Results: before nursing intervention, there was no significant difference in the level of serum CRP- ALBN TP between the two groups (P 0.05), and the level of CRP- ALBN TP in the two groups was improved after nutritional treatment and nursing intervention, but the improvement in the trial group was significantly higher than that in the control group.The difference between the two groups was statistically significant (P 0.05).There was no significant difference in BMI index between the test group and the control group after treatment (P 0.05).At the same time, the time of getting out of bed for the first time, the time of mechanical ventilation, the time of relieving abdominal distension, the time of recovery of blood amylase and urine amylase were significantly lower than those of the control group (P 0.05).The complications of abdominal distension, diarrhea, nausea and vomiting and hemorrhage of upper digestive tract in the two groups were significantly lower than those in the control group (P 0.05).Conclusion: transnasal jejunal nutrition support therapy can effectively correct severe acute pancreatitis malnutrition at the same time can also play a protective role in gastrointestinal tract and reduce the incidence of complications.Good clinical nursing intervention can ensure the smooth implementation of enteral nutrition.
【作者单位】：浙江省衢州市人民医院消化内科;
【分类号】：R473.5

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