内镜下空肠管置管与全肠外营养对急性胰腺炎患者肠内营养效果的比较

Xuejun Li
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引用次数: 0

摘要

目的比较内镜下空肠置管肠内营养(EN)与全肠外营养(TPN)治疗急性胰腺炎的疗效。方法选取2012年3月至2019年12月空军中央战区医院收治的急性胰腺炎患者60例,采用随机数字表法分为对照组和观察组,每组30例。对照组采用TPN,观察组采用内镜下空肠置管方式给予EN。比较两组患者的营养水平,包括血清白蛋白(ALB)、前白蛋白(PA)、康复质量(ApacheⅡ)、血淀粉酶水平、c反应蛋白(CRP)、临床疗效及并发症。结果观察组患者治疗后14 d ALB、PA水平均高于对照组(P<0.05)。观察组患者治疗后7、14 d ApacheⅡ评分均低于对照组(P<0.05)。观察组患者治疗后14 d血淀粉酶、CRP水平均低于对照组(P<0.05)。观察组总临床有效率为86.67%(26/30),高于对照组的63.33%(19/30),差异有统计学意义(P<0.05)。观察组并发症发生率为13.33%(4/30),低于对照组36.67% (11/30)(P<0.05)。结论EN经内镜下空肠置管可有效改善急性胰腺炎患者的营养水平,提高康复质量,减少并发症的发生。关键词:空肠饲管;急性胰腺炎;康复质量;并发症
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A comparison of effects of enteral nutrition by endoscopic jejunal feeding tube placement versus total parenteral nutrition on patients with acute pancreatitis
Objective To compare the effects of enteral nutrition (EN) by endoscopic jejunal feeding tube placement and total parenteral nutrition (TPN) on patients with acute pancreatitis. Methods A total of 60 patient with acute pancreatitis treated in Central Theater Air Force Hospital from March 2012 to December 2019 were enrolled, and they were divided into control group and observation group by random number table method, with 30 cases in each group. Control group received the TPN, while the observation group received the EN by endoscopic jejunal feeding tube placement. Then, the nutrition level, including serum albumin (ALB), prealbumin (PA), rehabilitation quality (ApacheⅡ), blood amylase level, C-reactive protein (CRP), clinical efficacy and complications were compared between the two groups. Results The ALB and PA levels of the observation group were higher than those of the control group on 14 d after treatment (P<0.05). The Apache Ⅱ scores of the observation group were lower than those of the control group on 7 and 14 d after treatment (P<0.05). The blood amylase level and CRP in the observation group was lower than that in the control group on 14 d after treatment (P<0.05). The total clinical efficacy rate of the observation group was 86.67% (26/30), higher than the 63.33% (19/30) of the control group (P<0.05). The incidence of the complications in the observation group was 13.33% (4/30), lower than the 36.67% (11/30) in the control group (P<0.05). Conclusions EN by endoscopic jejunal feeding tube placement can effectively ameliorate the nutritional level, improve quality of rehabilitation, reduce incidence of complications of patients with acute pancreatitis. Key words: Jejunal feeding tube; Acute pancreatitis; Rehabilitation quality; Complications
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