三腔喂养管在重症急性胰腺炎肠内营养治疗中应用.docVIP

三腔喂养管在重症急性胰腺炎肠内营养治疗中的应用 　　作者：陈生贵　　作者单位： 四川攀枝花，攀枝花学院附属医院肝胆外科(△普外科) 　　【摘要】探讨三腔营养管在重症急性胰腺炎(SAP)肠内营养(EN)中的应用价值。方法 将80例SAP患者随机分成三腔组和对照组各40例，三腔组置入FRECA三腔喂养管(华瑞制药生产)，一腔置于Trials韧带20 cm以下进行肠内营养，一腔置于胃内引流胃液，另一腔置入空肠充气预防营养液返流;对照组置普通胃肠营养管进行EN，观察两组临床指标。结果 三腔组1周APACHEⅡ评分为8.8±1.9，2周Balthaza CT评分为3.5±1.2，2周血清清蛋白水平(28.6±1.6)g/L，严重并发症发生率12.5%(5/40)，严重腹胀发生率30%(12/40)，血淀粉酶降至正常时间(5.6±2.4)天，住院时间(53.2±11.6)天，手术干预率5%(2/40)，对照组对应指标分别为10.2±2.5，4.2±1.6，(29.3±1.5)g/L，35%(14/40)，77.5%(31/40)，(6.9±1.6)天，(60.6±8.6)天，20%(8/40)，二组差异均有统计学意义(Ρ0.05)，病死率7.5%(3/40)vs 15%(6/40)(P0.05)。结论 对SAP患者行EN，应用三腔营养管，既能使肠内营养有效，又能减轻胰腺负担，疗效较满意。 　　【关键词】 三腔营养管 急性重症胰腺炎 肠内营养 　　Application of three-cave-nutrient-canal in enteral nutrition in severe acute pancreatitis 　　CHEN Sheng-gui，HUANG Qiong-fang，ZHANG Fu-xin，et al.Department of Hepatobiliary Surgery，Affiliated Hospital of Panzhihua College，Panzhihua 617000，China 　　[Abstract] Objective To investigate the clinical contribution of the three-cave-nutrient-canal in enteral nutrition in severe acute Pancreatitis(SAP).Methods 80 patients with SAP were equated into two groups randomly.In the treatment group，the three -cave-nutrient-canals one end was placed in stomach to drain gastric juice，the other end was in jejunum beyond the trials ligament 20 cm to give enteral nutrition，the third end was filling gas to prevent nutrition′s back flow.But in the control group，the common stomach tube was placed in stomach to give nutrition.Their clinical indexes were observed.Results In the treatment group，after 1 week the APACHEⅡ score was 8.8±1.9，after 2 weeks Balthaza CT score 3.5±1.2，the SAB 28.6±1.6 g/L，the time of hemodiastase dropped to normal 5.6±2.4 days，severe complication 12.5%(5/40)，severe abdominal distension 30%(12/40)，the length of stay 53.2±11.6 days，and those in the control group were 10.2±2.5，4.2±1.6，29.3±1.6 g/L，6.9±1.6 days，35%(14/40)，77.5%(31/40)，60.6±8.6 days.The differences between the treatment group and the control group had statistical significa