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目的探讨经鼻-空肠管早期肠内营养支持治疗重症急性胰腺炎(SAP)的临床意义。方法选取2011年1月至2014年9月于深圳市罗湖区人民医院就诊的SAP患者80例,随机分为对照组和观察组,每组40例。在综合治疗的基础上,对照组行完全肠外营养支持,观察组行经鼻-空肠管早期肠内营养支持,对比分析两组患者的临床疗效、营养状况及不良反应发生情况。结果经治疗后,观察组患者血清C-反应蛋白(CRP)水平较对照组显著降低,而白蛋白(ALB)及血清总蛋白(TP)水平较对照组显著升高(P<0.05);观察组患者腹胀缓解时间、血淀粉酶恢复时间、尿淀粉酶恢复时间及住院时间较对照组显著缩短(P<0.05);观察组患者治疗后APACHEⅡ评分较对照组显著降低(P<0.05);两组患者均未出现严重不良反应。结论经鼻-空肠管早期肠内营养支持治疗SAP,可有效改善患者的肠道黏膜屏障功能,提高机体免疫力,同时可改善其营养状况,促进患者病情的恢复。
Objective To investigate the clinical significance of nasogastrointestinal jejunal early enteral nutrition support for the treatment of severe acute pancreatitis (SAP). Methods From January 2011 to September 2014, 80 patients with SAP in the People’s Hospital of Luohu District, Shenzhen were randomly divided into control group and observation group, 40 cases in each group. On the basis of comprehensive treatment, the control group underwent complete parenteral nutrition support, and the observation group underwent nasogastrointestinal jejunal early enteral nutrition support. The clinical efficacy, nutritional status and adverse reactions of the two groups were compared and analyzed. Results After treatment, the serum level of C-reactive protein (CRP) in the observation group was significantly lower than that in the control group, while albumin (ALB) and serum total protein (TP) levels were significantly higher than those in the control group (P <0.05) The duration of bloating relieving, blood amylase recovery, urinary amylase recovery time and hospital stay were significantly shorter than those in the control group (P <0.05). APACHEⅡ score in the observation group was significantly lower than that in the control group (P <0.05); None of the patients experienced serious adverse reactions. Conclusion Nasogastrointestinal jejunal early enteral nutrition support treatment of SAP, can effectively improve the patient’s intestinal mucosal barrier function, improve immunity, while improving their nutritional status, and promote the recovery of patients.