早期肠内营养对重症急性胰腺炎肠源性感染影响临床研究.doc

早期肠内营养对重症急性胰腺炎肠源性感染影响临床研究 　　[摘要] 目的 探讨早期肠内营养对重症急性胰腺炎肠源性感染的影响，以期提高临床治疗水平。方法 随机选取2010年1月～2013年2月120例重症急性胰腺炎患者为研究对象，分成两组，1组为肠内营养，1组为肠外营养。比较各组在肠源性感染指标上的变化情况。结果 对照组治愈55例，死亡5例，死亡率为8.33%；观察组治愈56例，死亡4例，死亡率为6.67%。均未发生消化道穿孔、胰周脓肿等并发症。对照组出现腹胀4例，腹泻6例，经过调节输入速度和体位后缓解，观察组未见明显异常；在肠源性感染指标上，肠外营养和肠内营养在WBC、CRP、内毒素上比较有明显差异（P0.05）；而在肠内营养中，入院后第2天肠内营养和入院后第4天、第6天肠内营养在WBC、CRP、内毒素上比较有明显差异（P0.05）。 结论 早期肠内营养可降低重症急性胰腺炎肠源性感染的发生发展。 　　[关键词] 早期；肠内营养；重症急性胰腺炎；肠源性感染 　　[中图分类号] R576 [文献标识码] B [文章编号] 1673-9701（2014）02-0016-03 　　Clinical study of early enteral nutrition on intestinal infection of severe acute pancreatitis 　　XU Yiping1 HE Zhuoya1 YANG Guocai1 LI Jianhai2 　　1.Department of Surgery， Traditional Chinese Medicial Hospital of Zhuji in Zhejiang Province， Zhuji 311800， China； 2. Department of General Surgery，the First Peoples Hospital of Hangzhou， Hangzhou 321260， China 　　[Abstract] Objective To study the impact of early enteral nutrition on enterogenic infection in severe acute pancreatitis，and improve the level of clinical treatment. Methods 120 cases of severe acute pancreatitis patients were selected as the research object from January 2010 to February 2013， they were randomly divided into two groups， one group was treated with enteral nutrition， while the other group was treated with parenteral nutrition， the index changes of enterogenic infection were compared between the two groups. Results In the control group， 55 cases were cured， 5 cases were died， the mortality rate was 8.33%； while in the observation group， 56 cases were cured， 4 cases were died， the mortality rate was 6.67%. No one case had the complications such as gaslrointestinal perforation and peripancreatic abscess. In the control group， 4 cases had abdominal distension， 6 cases had diarrhea， but after adjusting the input speed and position， the symptoms were relieved， while the patients in the observation group had no obvious abnormal symptom； there were significant differences between the two groups in index of WBC， CRP