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目的:对比研究不同时机经三腔胃肠管给予EN治疗重症急性胰腺炎(SAP)的效果。方法:43例SAP病人均在入院48 h内放置三腔胃肠管行胃肠减压,随机分为A组(n=20)和B组(n=23)。A组在患病48~168 h(平均109.2 h)经三腔胃肠管途径给予EN,B组在患病48 h内(平均30.7 h)经三腔胃肠管途径给予EN。观察病人治疗7和14 d时APACHE-Ⅱ评分、BalthazarCT积分、C反应蛋白(CRP)和肠道功能恢复时间等。结果:治疗7d时,B组APACHE-Ⅱ评分较A组明显降低(P<0.05);CRP恢复时间较A组明显缩短(P<0.05),住院费用亦低于A组。结论:早期(患病48 h内)给予EN,能有效地控制SAP的全身炎症反应,减少感染的发生率,缩短病程。
OBJECTIVE: To compare the effect of enteral nutrition with EN at three different stages on the treatment of severe acute pancreatitis (SAP). Methods: Forty-three SAP patients underwent gastrointestinal decompression within 48 hours after admission and were randomly divided into group A (n = 20) and group B (n = 23). Group A received EN through the triple-lumen gastrointestinal tract during 48-168 h (average 109.2 h), and EN through the triple-lumen gastrointestinal tract within 48 h (average 30.7 h). APACHE-Ⅱ score, BalthazarCT score, C-reactive protein (CRP) and intestinal function recovery time were observed at 7 and 14 days after treatment. Results: On the 7th day of treatment, the APACHE-Ⅱ score of group B was significantly lower than that of group A (P <0.05). The recovery time of CRP was significantly shorter than that of group A (P <0.05). The hospitalization cost was also lower than that of group A. Conclusion: Early (within 48 hours of illness) given EN, can effectively control systemic inflammatory response in SAP, reduce the incidence of infection and shorten the course of disease.