摘要
目的探讨早期阶梯式营养管理对重症急性胰腺炎(SAP)患者喂养不耐受的影响。方法选取2021年9月—2022年12月医院就诊的SAP患者103例为研究对象,按照组间基本资料具有可比性的原则分为对照组51例和观察组52例,两组患者均予以禁食水、胃肠减压等综合治疗,对照组给予基础营养干预,即在患者入院后根据患者基础情况通过外周静脉置管补充其所需的营养,持续输注直至患者正常经口进食方可停止。观察组患者入院3 d后在对照组基础上予以肠外营养支持,并于入院第4天改为肠内营养,在肠内营养干预首日输注等渗盐水做好肠道喂养准备,第2天可予以半量百普力并逐步过渡至全量,在持续干预2周后逐步减量直至患者进口进食方可停止干预。观察并分析两组患者病情恢复情况、营养状况、胰腺炎酶类指标、喂养不耐受情况。结果观察组患者腹痛及腹胀缓解时间及肠鸣音恢复均短于对照组,差异有统计学意义(P<0.05)。干预前,两组患者营养状况(ALB、TP、TFR及PA)比较差异均无统计学意义(P>0.05);干预后观察组患者ALB、TP、TFR及PA水平均高于对照组,差异有统计学意义(P<0.05)。观察组患者血及尿淀粉酶恢复时间较短于对照组,差异有统计学意义(P<0.05);观察组患者喂养不耐受发生率低于对照组,差异有统计学意义(P<0.05)。结论相比于单一接受基础营养干预的患者,对接受胃肠减压的SAP患者予以早期阶梯式营养管理可改善其营养状况,降低喂养不耐受发生率,缩短各临床症状改善时间,促进患者疾病恢复。
Objective To investigate the effects of early stepwise nutritional management applied to feeding intolerance in patients with severe acute pancreatitis(SAP).Methods To select 103 cases of SAP patients who visited the hospital from September 2021 to December 2022 for the study,they were divided into 51 cases in the control group and 52 cases in the observation group according to the principle of comparability of basic data between groups,comprehensive treatments such as water fasting and gastrointestinal decompression,etc.were given to the two groups.The basic nutritional intervention was given to the control group,according to the basic conditions of the patients after admission,the patients were supplemented with nutrition through peripheral intravenous tube.The control group was given the basic nutritional intervention.After hospitalization,depending on the basic condition of the patients,the necessary nutrition was supplemented through the peripheral intravenous cannula,and the infusion was continued until the patients ate normally by mouth.Patients in the observation group received parenteral nutrition after 3 days of admission,based on the control group,and switched to enteral nutrition on the 4th day of admission.On the first day of the enteral nutrition intervention,isotonic saline was infused to prepare for enteral feeding,and on the second day half of the pepcid was given,and the transitioned to the full dose gradually,and the intervention could only be stopped when the patients were introduced to eating after 2 weeks of continuous intervention,and the dosage was gradually reduced.Observation and analysis of condition recovery,nutritional status,pancreatitis enzyme indices and food intolerance of the two groups.Results The time to relief of abdominal pain and distension and the recovery of bowel sounds were shorter in the observation group than the control group,and the difference was statistically significant(P<0.05).Before the intervention,the difference in nutritional status(ALB,TP,TFR and PA)between the two groups was not statistically significant(P>0.05),After the intervention,the levels of ALB,TP,TFR and PA in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The blood and urine amylase recovery time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05);the incidence of feed intolerance of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with patients receiving only basic nutritional intervention,early stepwise nutritional management of SAP patients undergoing gastrointestinal decompression can improve their nutritional status,reduce the incidence of feeding intolerance,shorten the time of improvement of clinical symptoms,and promote patients'recovery.
作者
涂洁
李燕
杨萱翠
晏燕
李萍
TU Jie;LI Yan;YANG Xuancui;YAN Yan;LI Ping(Fengcheng People's Hospital,Fengcheng 331100,China)
出处
《护理实践与研究》
2025年第1期40-45,共6页
Nursing Practice and Research
基金
江西省卫生健康委科技计划项目(编号:SKJP220218705)。
关键词
早期阶梯式营养管理
重症胰腺炎
营养状况
喂养不耐受
影响
Early stepwise feeding management
Severe pancreatitis
Nutritional status
Feeding intolerance
Influence
