全肠内外营养在急性重症胰腺炎胰腺坏死性感染的作用分析.docVIP

全肠内、外营养在急性重症胰腺炎胰腺坏死性感染的作用分析 刘海峰 赵浩亮( 田彦璋 (山西医科大学附属山西医学科学院 山西大医院，太原，山西 030001) 【摘 要】目的：评价全肠内营养在预防重症胰腺炎胰腺坏死性感染、死亡率及并发症等中的作用。方法：随机选择2013年12月-2014年12月我院收治的60例确诊为重症胰腺炎入住ICU的患者作为观察对象，其中接受全肠外营养联合抗生素治疗和接受全肠内营养联合抗生素治疗的患者各30例，观察两组患者外科干预情况及胰腺感染坏死类型、死亡率等情况。结果：观察组手术干预例数、再手术例数及手术出血量低于对照组，差异有统计学意义（P0.05）,观察组从发病到手术时间较对照组长，差异有统计学意义（P0.05），两组在手术持续时间方面差异无统计学意义（P0.05）；观察组主要以无菌性坏死为主，对照组以感染性坏死为主，差异有统计学意义（P0.05）；观察组病死率为13.33%，对照组为36.67%，差异有统计学意义（P0.05）；观察组并发症发生率低于对照组，差异有统计学意义（P0.05）。结论：重症急性胰腺炎坏死性感染患者应优先进行全肠内营养，效果较好。 【关键词】重症胰腺炎 全肠内营养 感染 手术治疗 Effects of total internal nutrition and parenteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis [Abstract] Objectives: To evaluate the prevention effect of total internal nutrition in pancreatic necrotic infection of severe acute pancreatitis. Methods:60 cases were enrolled randomly between December 2013 and December 2014. The patients were divided into two groups named observation group and control group, and each group contains 30 patients. The observation group received total internal nutrition and the control group received total parenteral nutrition, we aimed to observe the incidence rate of pancreatic septic necroses, surgical intervention as well as complication rate. Results: Cases of surgical intervention and blood loss in observation group were lower than control group(P0.05). The operative time in the observe group was longer than control group（P0.05）. Aseptic necrosis was observed mainly in the observation group, while infection necrosis was mainly in control group(P0.05). The incidence rate in observation group was 13.33 percent and 36.67 percent in control group(P0.05). The complication rate in observation group was lower than in the control group(P0.05). Conclusion: Total internal nutrition is prior than total parenteral nutrition in prevention of pancreatic necrotic infection in severe acute pancreatitis. [Keywords] severe acute pancreatitis; total internal nutrition; surgery; infection 急