鼻胃管肠内营养对中—重度急性胰腺炎的临床疗效研究

发布时间：2018-03-08 16:01

本文选题：中-重度急性胰腺炎　切入点：肠内营养　出处：《肠外与肠内营养》2017年05期 　论文类型：期刊论文

【摘要】：目的 :探讨鼻胃管肠内营养(NGEN)在中-重度急性胰腺炎(M-SAP)治疗中的临床疗效、安全性及耐受性。方法 :收集2013年11月至2014年8月我院消化科住院病人中符合诊断标准的M-SAP病人60例,其中30例使用鼻胃管予以肠内营养(EN),30例使用鼻空肠管进行EN,比较两组病人在肠道通透性(内毒素、D-乳酸)、炎症反应指标(CRP、IL-6、TNFα)、营养情况、管饲副作用(反流误吸、腹痛加重、腹泻)的发生率及病人病情评估(APACHE II评分、MCTSI评分)、预后(感染并发症发生率、病死率、住院时间、住院费用)等方面差异是否存在统计学意义。结果 :在肠道通透性、炎症反应指标、营养状况评价、整体病情评估、预后等方面,两组差异无统计学意义(P0.05),但在反流误吸上,鼻胃管肠内营养组(NG组)发生率为20%,鼻空肠管肠内营养组(NJ组)为3.3%,差异有统计学意义(P0.05)。结论:M-SAP患者行NGEN治疗与鼻空肠管肠内营养(NJEN)在SAP病情变化、营养情况、肠道通透性、预后等方面作用相当,NGEN方法简便,值得临床重视。NGEN发生反流误吸风险较NJEN大,其在M-SAP应用的安全性方面,尚需更多大样本随机对照实验加以研究。
[Abstract]:Objective: to investigate the clinical effect of enteral nutrition of nasogastric tube (NEN) in the treatment of moderate to severe acute pancreatitis (MRAP). Methods: from November 2013 to August 2014, 60 patients with M-SAP who met the diagnostic criteria were collected. Among them, 30 cases were given enteral nutrition by nasogastric tube and 30 cases were given en by naso-jejunal tube. The intestinal permeability (endotoxin D- lactic acid), inflammatory response index (CRP) IL-6 TNF- 伪, nutritional status, side effect of tube feeding (reflux missuction, abdominal pain) were compared between the two groups. There were statistically significant differences in the incidence of diarrhea and the patient's condition assessment, Apache II score, MCTSI score, prognosis (incidence of infection complications, mortality, length of stay, hospitalization cost). There was no significant difference between the two groups in inflammatory response index, nutritional status evaluation, overall condition evaluation, prognosis and so on, but there was no significant difference between the two groups in reflux aspiration. The incidence of NGEN was 20 in the nasogastric tube enteral nutrition group, and 3.3 in the nasal jejunal tube enteral nutrition group (P 0.05). Conclusion NGEN therapy and enteral nutrition of the naso-jejunal tube and enteral nutrition can be performed in the patients with SAP. The effect of NGEN on prognosis is quite simple and worthy of clinical attention. The risk of regurgitation is higher than that of NJEN. The safety of NGEN in M-SAP application needs to be studied in a large sample of randomized controlled trials.
【作者单位】：西南医科大学附属医院消化内科;
【基金】：四川省泸州市科技局项目[2014-S-48(12/12)]
【分类号】：R576

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