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[目的]探讨不同营养支持方式对重症急性胰腺炎患者的影响及临床应用价值。[方法]将80例重症急性胰腺炎患者采用随机数字表法分为观察组与对照组,对照组给予全肠外营养,观察组联合早期肠内营养支持,对比治疗效果。[结果]观察组治疗后Ransons评分(1.11±0.30)分,APACHEII评分(4.68±1.87)分;对照组治疗后Ransons评分(1.57±0.68)分,APACHEII评分(8.73±2.95)分,组间对比差异有统计学意义(t=3.9144、7.3336;P<0.05)。观察组治疗后C反应蛋白(31.53±8.96)mg/L,血浆内毒素(0.09±0.02)EU/ml;对照组治疗后C反应蛋白(53.47±14.25)mg/L,血浆内毒素(0.21±0.08)EU/ml,组间对比差异有统计学意义(t=8.2435、9.2036;P<0.05)。观察组发生腹胀腹泻4例,感染2例,多器官功能不全2例,高血糖1例;对照组发生腹胀腹泻13例,感染10例,多器官功能不全8例,高血糖7例,组间对比差异有统计学意义(χ2=6.0504、6.2745、4.1143、5.0000;P<0.05)。[结论]早期肠内营养应用在重症胰腺炎患者中可以维持肠道黏膜的屏障功能,减轻患者体内炎症反应,降低体内内毒素浓度,降低并发症发生,缩短康复时间,值得在临床上推广应用。
[Objective] To investigate the effect of different nutritional support methods on patients with severe acute pancreatitis and its clinical value. [Methods] Eighty patients with severe acute pancreatitis were divided into observation group and control group by random number table. The control group was given total parenteral nutrition, and the observation group combined with early enteral nutrition support. The therapeutic effect was compared. [Results] Ransons score (1.11 ± 0.30) and APACHEII score (4.68 ± 1.87) in observation group after treatment; Ransons score (1.57 ± 0.68) and APACHEII score (8.73 ± 2.95) in control group after treatment, The difference was statistically significant (t = 3.9144, 7.3336; P <0.05). After treatment, C-reactive protein (31.53 ± 8.96) mg / L and plasma endotoxin (0.09 ± 0.02) EU / ml in the observation group were significantly higher than those in the control group (53.47 ± 14.25 mg / 0.08) EU / ml, the difference between the two groups was statistically significant (t = 8.2435,9.2036; P <0.05). The observation group had abdominal distension and diarrhea in 4 cases, infection in 2 cases, multiple organ dysfunction in 2 cases and hyperglycemia in 1 case. The control group had abdominal distension and diarrhea in 13 cases, infection in 10 cases, multiple organ dysfunction in 8 cases, hyperglycemia in 7 cases, The difference was statistically significant (χ2 = 6.0504,6.2745,4.1143,5.0000; P <0.05). [Conclusion] The application of early enteral nutrition in severe pancreatitis patients can maintain the barrier function of intestinal mucosa, reduce the patient’s inflammatory reaction, reduce the concentration of endotoxin in the body, reduce the occurrence of complications and shorten the recovery time, which is worth popularizing in clinic .