营养支持在重症胰腺炎后局部并发症治疗中的意义

发布时间：2018-11-11 18:27

【摘要】：目的探讨肠内营养(EN)与全肠外营养(TPN)对急性重症胰腺炎(SAP)后局部并发症的影响。方法回顾性分析该院2005年12月至2015年2月收治的210例SAP后胰腺局部并发症(胰周积液、假性囊肿)患者的临床资料,按不同营养方式分为EN组[经皮内镜下胃/空肠造口(PEG/PEJ)和鼻空肠管],以及TPN组,比较两组营养情况(清蛋白、血红蛋白、淋巴细胞)、并发症转归、病死率,以及EN组2种营养方式操作相关性并发症的发生率。结果 EN组与全肠外营养组比较,淋巴细胞、清蛋白、血红蛋白均较后者增高,差异均有统计学意义(P0.05),出现新并发症的概率及病死率均降低,差异均有统计学意义(P0.05);不同并发症中EN与TPN比较减少、完全吸收时间差异均无统计学意义(P0.05);2种EN操作相关性并发症发生率比较,鼻空肠管组较经皮胃空肠造瘘术组增高,差异有统计学意义(P0.05)。结论SAP后局部并发症患者禁食时间较长,有效的营养支持是必要的,而EN疗效明显优于全肠外营养,其中PEG/PEJ较鼻空肠管并发症少,适合临床应用。
[Abstract]:Objective to investigate the effects of enteral nutrition (EN) and total parenteral nutrition (TPN) on local complications after (SAP) in severe acute pancreatitis. Methods the clinical data of 210 patients with pancreatic complications (peripancreatic effusion, pseudocyst) treated in our hospital from December 2005 to February 2015 were retrospectively analyzed. According to different nutrition methods, EN group [PEG/PEJ and naso-jejunostomy (PEG/PEJ)] and TPN group were divided into two groups. The nutritional status (albumin, hemoglobin, lymphocyte), complications and mortality were compared between the two groups. And the incidence of complications associated with two nutritional practices in EN group. Results compared with the total parenteral nutrition group, lymphocyte, albumin and hemoglobin in EN group were significantly higher than those in the latter group (P0.05). The difference was statistically significant (P0.05). In different complications, EN and TPN decreased, and there was no significant difference in total absorption time (P0.05). The incidence of complications associated with EN was significantly higher in the naso-jejunal group than in the percutaneous gastrojejunostomy group (P0.05). Conclusion the time of fasting is longer in patients with local complications after SAP, and effective nutritional support is necessary, and the curative effect of EN is better than that of total parenteral nutrition. PEG/PEJ is suitable for clinical application because of its less complications than that of naso-jejunal tract.
【作者单位】：重庆医科大学附属第一医院消化内科;
【分类号】：R576;R459.3

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