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(P<0.05),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(P<0.05);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(P>0.05);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(P<0.05)。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。
Objective To explore the influence of the enteral nutrition（EN） and total parenteral nutrition（TPN） on local complications in severe acute pancreatitis （SAP）. Methods The clinical data of 210 patients with local complications （peripan-creatic effusion,pseudocyst） after SAP treated in our hospital from December 2005 to February 2015 were retrospectively ana-lyzed. These cases were divided into the EN group[percutaneous endoscopic gastric/jejunum stoma （PEG/PEJ） and nasal jejunal feeding tube] and the TPN group. The nutrition situation （albumin,HGB,lymphocyte）,complication outcome and mortality rate were compared between the two groups ,and the occurrence rates of 2-kind nutritional mode operation associated complications were compared too. Results Compared with the TPN group,the HGB,lymphocyte and ALB levels in the EN group were in-creased with statistical difference（P〈0.05）,the probability of new complication appearance and mortality rate were decreased with statistical difference （P〈0.05）,but the reduced and completely absorption time of different complications had no statistical differ-ences between the EN group and the TPN group（P〉0.05）;the occurrence rate of 2-kind EN operation related complications in the nasal jejunal tube group was increased compared with the gastric jejunal stoma group ,the difference was statistically signifi-cant（P〈0.05）. Conclusion The patients with local complications after SAP have fasting for a long time,an effective nutrition support is necessary. The effect of EN is obviously superior to TPN ,in which PEG/PEJ has little complications than nasal jejunal feeding tube and is suitable for clinical application.
出处
《现代医药卫生》
2016年第10期1473-1475,共3页
Journal of Modern Medicine & Health
关键词
胃肠外营养
胰腺炎
肠道营养
胆道疾病
肠内营养
Parenteral nutrition
Pancreatitis
Enteral nutrition
Biliary tract diseases
