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1、重症急性胰腺炎的营养支持治疗姚志勲'吕永添2彭烈标I姚少林I
2、广东省汕头市潮阳区人民医院普外科(潮阳515100);彳屮山人学第二附属医院胃肠外科(广州510120)【摘要】H的研究不同营养途径对重症急性胰腺炎(SAP)病人营养及预后的影响。方法回顾性分析42例SAP病人,分为早期肠内营养(EEN组,—21)及完全肠外营养(TPN组,n=21)。EEN组在入院后3〜6天均通过空肠营养管输注冇普素(Pepti・2000variant),两组了等热量、等氮量,总热量3()kcal/kg-d,氮量为0.17g/kg・d。结果①EEN组死亡率低于TPN组,但无显著性差
3、异(P>0.05),EEN纟H.住院天数明显少于TPN组(PV0.01);②入院后2周:EEN纽血红蛋白、体重高于TPN组,但无显著性差异;血浆总蛋白、白蛋白高于TPN组(PV0.05);前白蛋白明显高于TPN组(P<0.01)o结论与TPN支持相对比,EENnJ-有效地改善SAP病人的营养状态,缩短住院时间。【关健词】重症急性胰腺炎;肠内营养;肠外营养ThenutritionalsupportforthepatienswithsevereacutepancreatitisYAOZhixun1,LVYongtian2,PENGLiebiao,YAOShaoli
4、n1.'ThePeople'sHospitalofChaoyangDistric,ShantouCity515100,China;DepartmentofGastrointestinalSurgery,TheSecondAffiliatedHospitai,SunYat-senUniversity,Guangzhou510120,china[Abstract]ObjectiveTocomparetheeffectsofearlyenteralnutrition(EEN)supportandtotalparenteralnutrition(TPN)support
5、forthepatienswithsevereacutepancreatitis(SAP).Methods42casesofSAPwerestudiedrestrospectivelyandthepatiensweredividedintotwogroupsrandomly:earlyenteralnutritiongroup(EENgroup,n二21),totalparenteralnutritiongroup(TPNgroup,21).Pepti-2000wastransfusedthroughnasojejunaltubeinthe3rdtothe6t
6、hdayafteradmissioninEENgroup.Thecaloryandnitrogeninbothgroupswere30kcal/kg*dand0」7g/kg・d.Results①ThedeathrateinlheEENgroupwaslowerthanthatintheTPNgroup,buttherewerenodifferencesbetweentwogroups(p>0.05);thehospitalizeddaysinEENgroupwerelessthanthatintheTPNgroup(P<0.05).②Inthetwoweeks
7、afteradmission:hemoglobinandbodyweightinEENgroupworemeasuredmorethanthatinTPNgroup,butnosignificantdifferenccwasfound;plasmatotalprotoinandalbumininEENgroupweremeasuredmorethanthatinTPNgroup(p<0.05);sndmoreprealbuminwasfoundinEENgroup.ConclusionsComparedtoTPNsupport,earlyEENsupporti
8、smoreefficienttoimprovebodynutritionconditionandshortenshospitalizeddays.[Keywords]Severeacutepancreatitis;Enteralnutrition;Parenteralnutrition营养支持治疗是SAP综合治疗的重要组成部分,-其方式和方法的选择対改善SAP病人全身状况、防治肠道功能衰竭、减轻全身性炎症反应、减少感染机会以及改善预后尤为重要。在实施营养支持时,必须针对肠内与肠外营养支持的利弊,来选择营养支持的方式。现将1997.6〜2005.6收治的42例S
9、AP病人(中山大学笫二附属医院25例,