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目的:探讨留置胃管持续负压盘吸引联合鼻空肠置管进行早期肠内营养和肠外营养支持对于重症急性胰腺炎(SAP)预后的影响。方法:将SAP患者随机分为研究组22例和对照组23例,研究组患者自确诊SAP后立即留置胃管持续负压盘吸引联合鼻空肠置管进行早期肠内营养支持治疗,对照组患者均采用单纯胃肠减压和肠外营养支持治疗。比较两组患者危重症评分(APACHEⅡ)情况、血清白蛋白水平、CRP水平、通便时间、腹痛缓解时间、置管时间、肠鸣音恢复时间、血淀粉酶恢复正常时间。结果:两组患者治疗当天APACHEⅡ评分差异无统计学意义(P>0.05)。随着治疗时间的增加两组的APACHEⅡ评分均逐渐下降,研究组治疗后7 d明显低于对照组(P<0.05);研究组治疗后10天血清白蛋白水平明显高于对照组(P<0.05);血CRP水平明显低于对照组(P<0.05);研究组通便时间、置管时间、肠鸣音恢复时间、血淀粉酶恢复正常时间明显短于对照组(P<0.05)。两组患者腹痛缓解时间无统计学意义(P>0.05)。结论:早期留置胃管持续负压盘吸引联合鼻空肠置管早期肠内营养治疗对于SAP患者的治疗较单纯胃肠减压和肠外营养支持效果更佳。
OBJECTIVE: To investigate the effect of gastric tube continuous negative pressure plate suction combined with nasal jejunal tube for early enteral nutrition and parenteral nutrition support on the prognosis of severe acute pancreatitis (SAP). Methods: SAP patients were randomly divided into study group 22 cases and control group 23 cases. Patients in the study group were treated with SAP immediately after the definite diagnosis of SAP with continuous negative pressure plate suction and nasal jejunal catheter for early enteral nutrition support. Patients in the control group Both simple gastrointestinal decompression and parenteral nutrition support treatment. Serum albumin level, CRP level, laxative time, abdominal pain relief time, catheterization time, bowel sounds recovery time, blood amylase recovery time were compared between the two groups in patients with critical illness score (APACHEⅡ). Results: There was no significant difference in APACHEⅡscore between the two groups on the day of treatment (P> 0.05). With the increase of treatment time, APACHEⅡscore decreased gradually in both groups, and the level of serum albumin in study group was significantly higher than that in control group on the 7th day after treatment (P < 0.05). The blood CRP level was significantly lower than that of the control group (P <0.05). The study group laxative time, catheterization time, bowel sound recovery time, blood amylase recovery time was significantly shorter than the control group (P <0.05). Two groups of patients with abdominal pain relief time was not statistically significant (P> 0.05). CONCLUSIONS: Early indwelling gastric tube continuous negative pressure disk combined with nasogastric jejunal catheter for early enteral nutrition treatment is more effective than simple gastrointestinal decompression and parenteral nutrition support for patients with SAP.