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华西医学  2010 

全肠内营养支持对急性重症胰腺炎患者预后影响的临床观察

, PP. 2185-2188

Keywords: 急性重症胰腺炎,全肠内营养,全肠外营养,预后

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Abstract:

【】 目的 探讨比较全肠内营养支持和全肠外营养支持对急性重症胰腺炎(severeacutepamcreattis,SAP)预后的影响。 方法 将2003年1月-2008年12月收治的54例SAP患者于入院后第1周内随机分为两组全肠内营养(A)组27例;全肠外营养(B)组27例。两组患者均静脉给予广谱抗生素预防感染。入院时CT扫描及C反应蛋白水平显示两组患者具有可比性。 结果 B组22例患者发生器官衰竭,明显高于A组(5例)。B组22例患者接受了手术治疗,A组手术患者6例(P<0.05)。A组患者胰腺坏死后感染发生率明显低于B组(P<0.05)。B组患者死亡率高于A组(P<0.05)。 结论 全肠内营养支持,不仅可以促进肠道功能的恢复和营养状况的维持,还可减少肠源性感染的发生率,对减少SAP的感染性并发症和病死率具有积极作用。?【Abstract】 Objective Toevaluatetheeffectsoftotalenteralnutritionandtotalparenteralnutritionontheprognosisonsevereacutepancreatitis(SAP). Methods Atotalof54patientshospitalizedfromJanuary2003toDecember2008wereenrolled.Inthefirstweekofhospitalization,thepatientswererandomlydividedintotwogroups27patientsintotalparenteralnutritiongroup(groupA)and27patientsintotalenteralnutritiongroup(groupB).Allpatientswereadministeredwithsufficientprophylacticantibiotics.TheresultsofCTscanandC-reactiveproteinlevelswerecomparablebetweenthetwogroups. Results Twenty-twopatientshadorganfailureingroupB,whichwasmuchhigherthanthatingroupA(fivepatieuts).ThenumbersofthepatientsundertwentsurgicalinterventioningroupAandBwere22and6(P<0.05).TheincidenceofinfectionafterpancreaticsepticnecrosesingroupAwasobviouslylowerthanthatingroupB(P<0.05).ThemortalityingroupBwasapparentlyhigherthanthatingroupA(P<0.05). Conclusion Totalenteralnutritionsupportcannotonlypromotethefunctionalrecoveryofintestinaltractandsustainthenutritionofhumanbody,butalsodecreasetheincidenceofenterogenicinfection.

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