Effect of Total Enteral Nutrition Support on the Prognosis of Severe Acute Pancreatitis_West China Medical Journal

Authors：

ZHOU YanLin ¹ , DU Rong ² , XIAO Guangrong ¹

1. Department of General Surgery, People’s Hospital in Dujiangyan City, Dujiangyan, Sichuan 611830, P.R.China; 2. Nursing Institution of Chengdu University, Chengdu, Sichuan 610000, P.R.China;

Corresponding author：

Keywords：

急性重症胰腺炎; 全肠内营养; 全肠外营养; 预后

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【摘要】　目的　探讨比较全肠内营养支持和全肠外营养支持对急性重症胰腺炎（severe acute pamcreattis，SAP）预后的影响。　方法　将2003年1月-2008年12月收治的54例SAP患者于入院后第1周内随机分为两组:全肠内营养（A）组27例；全肠外营养（B）组27例。两组患者均静脉给予广谱抗生素预防感染。入院时CT扫描及C反应蛋白水平显示两组患者具有可比性。　结果　 B组22例患者发生器官衰竭，明显高于A组（5例）。B组22例患者接受了手术治疗，A组手术患者6例（P lt;0.05）。A组患者胰腺坏死后感染发生率明显低于B组（P lt;0.05）。B组患者死亡率高于A组（P lt;0.05）。　结论　全肠内营养支持，不仅可以促进肠道功能的恢复和营养状况的维持，还可减少肠源性感染的发生率，对减少SAP的感染性并发症和病死率具有积极作用。
【Abstract】　Objective　 To evaluate the effects of total enteral nutrition and total parenteral nutrition on the prognosis on severe acute pancreatitis (SAP).　Methods　 A total of 54 patients hospitalized from January 2003 to December 2008 were enrolled. In the first week of hospitalization, the patients were randomly divided into two groups: 27 patients in total parenteral nutrition group (group A) and 27 patients in total enteral nutrition group (group B). All patients were administered with sufficient prophylactic antibiotics. The results of CT scan and C-reactive protein levels were comparable between the two groups.　Results　 Twenty-two patients had organ failure in group B, which was much higher than that in group A (five patieuts). The numbers of the patients undertwent surgical intervention in group A and B were 22 and 6 (P lt;0.05). The incidence of infection after pancreatic septic necroses in group A was obviously lower than that in group B (P lt;0.05). The mortality in group B was apparently higher than that in group A (P lt;0.05).　Conclusion　 Total enteral nutrition support can not only promote the functional recovery of intestinal tract and sustain the nutrition of human body,but also decrease the incidence of enterogenic infection.

Citation： ZHOU YanLin,DU Rong,XIAO Guangrong. Effect of Total Enteral Nutrition Support on the Prognosis of Severe Acute Pancreatitis. West China Medical Journal, 2010, 25(12): 2185-2188. doi: Copy

1.	王兴鹏. 加强重症急性胰腺炎肠内营养的临床研究[J]. 中华医学杂志, 2004, 84(15): 1233-1234.
2.	王兴鹏, 许国铭, 袁宗耀, 等. 中国急性胰腺炎诊治指南(草案) [J]. 中华消化杂志, 2004, 24 (3): 190-192.
3.	Friedman LS. Liver, biliary tract and pancreas//Tierney LM, McPhee SJ, Papadakis MA. Current Medical Diagnosis and Treatment[M]. 45th ed. New York, NY: Lange Medical Books/McGraw-Hill, 2006: 693-701.
4.	Berzin TM, Rocha FG, Whang EE, et al. Prevalence of primary fungal infections in necrotizing pancreatitis[J]. Pancreatology, 2007, 7(1): 63-66.
5.	Lehocky P, Sarr MG. Early enteral feeding in severe acute pancreatitis: can it prevent secondary pancreatic (super) infection? [J]. Dig Surg, 2000, 17(6): 571-577.
6.	Gmen E, Klc YA, Yolda O, et al. Comparison and validation of scoring systems in a cohort of patients treated for biliary acute pancreatitis[J]. Pancreas, 2007, 34(1): 66-69.
7.	Rahman SH, Menon KV, Holmfield JH, et al. Serum macrophage migration inhibitory factor is an early marker of pancreatic necrosis in acute pancreatitis[J]. Ann Surg, 2007, 245(2): 282-289.
8.	Powell JJ, Murchison JT, Fearon KC, et al. Randomized controlled trial of the effect of early enteral nutrition on markers of the inflammatory response in predicted severe acute pancreatitis[J]. Br J Surg, 2000, 87(10): 1375-1381.
9.	Büchler MW, Gloor B, Müller CA, et al. Acute necrotizing pancreatitis: treatment strategy according to status of infection[J]. Ann Surg, 2000, 232(5): 619-626.
10.	Isenmann R, Runzi M, Kron M, et al. Prophylactic antibiotic treatment in patients with predicted severe acute pancreatitis: a placebo-controlled, double-blind trial[J]. Gastroenterology, 2004, 126(4): 997-1004.
11.	De Waele JJ, Delrue L, Hoste EA, et al. Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis: evaluation of a new scoring system[J]. Pancreas, 2007, 34(2): 185-190.
12.	McNaught CE, Woodcock NP, Mitchell CJ, et al. Gastric colonisation, intestinal permeability and septic morbidity in acute pancreatitis[J]. Pancreatology, 2002, 2(5): 463-468.
13.	Dellinger EP, Tellado JM, Soto NE, et al. Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study[J]. Ann Surg, 2007, 245(5): 674-683.
14.	Schietroma M, Carlei F, Lezoche E, et al. Acute biliary pancreatitis: staging and management[J]. Hepato-gastroenterology, 2001, 48(40): 988-993.
15.	Kumar A, Singh N, Prakash S, et al. Early enteral nutrition in severe acute pancreatitis: a prospective randomized controlled trial comparing nasojejunal and nasogastric routes[J]. J Clin Gastroenterol, 2006, 40(5): 431-434.
16.	Baril NB, Ralls PW, Wren SM, et al. Does an infected peripancreatic fluid collection or abscess mandate operation? [J]. Ann Surg, 2000, 231(3): 361-367.

1. 　王兴鹏. 加强重症急性胰腺炎肠内营养的临床研究[J]. 中华医学杂志, 2004, 84(15): 1233-1234.
2. 　王兴鹏, 许国铭, 袁宗耀, 等. 中国急性胰腺炎诊治指南(草案) [J]. 中华消化杂志, 2004, 24 (3): 190-192.
3. 　Friedman LS. Liver, biliary tract and pancreas//Tierney LM, McPhee SJ, Papadakis MA. Current Medical Diagnosis and Treatment[M]. 45th ed. New York, NY: Lange Medical Books/McGraw-Hill, 2006: 693-701.
4. 　Berzin TM, Rocha FG, Whang EE, et al. Prevalence of primary fungal infections in necrotizing pancreatitis[J]. Pancreatology, 2007, 7(1): 63-66.
5. 　Lehocky P, Sarr MG. Early enteral feeding in severe acute pancreatitis: can it prevent secondary pancreatic (super) infection? [J]. Dig Surg, 2000, 17(6): 571-577.
6. 　Gmen E, Klc YA, Yolda O, et al. Comparison and validation of scoring systems in a cohort of patients treated for biliary acute pancreatitis[J]. Pancreas, 2007, 34(1): 66-69.
7. 　Rahman SH, Menon KV, Holmfield JH, et al. Serum macrophage migration inhibitory factor is an early marker of pancreatic necrosis in acute pancreatitis[J]. Ann Surg, 2007, 245(2): 282-289.
8. 　Powell JJ, Murchison JT, Fearon KC, et al. Randomized controlled trial of the effect of early enteral nutrition on markers of the inflammatory response in predicted severe acute pancreatitis[J]. Br J Surg, 2000, 87(10): 1375-1381.
9. 　Büchler MW, Gloor B, Müller CA, et al. Acute necrotizing pancreatitis: treatment strategy according to status of infection[J]. Ann Surg, 2000, 232(5): 619-626.
10. 　Isenmann R, Runzi M, Kron M, et al. Prophylactic antibiotic treatment in patients with predicted severe acute pancreatitis: a placebo-controlled, double-blind trial[J]. Gastroenterology, 2004, 126(4): 997-1004.
11. 　De Waele JJ, Delrue L, Hoste EA, et al. Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis: evaluation of a new scoring system[J]. Pancreas, 2007, 34(2): 185-190.
12. 　McNaught CE, Woodcock NP, Mitchell CJ, et al. Gastric colonisation, intestinal permeability and septic morbidity in acute pancreatitis[J]. Pancreatology, 2002, 2(5): 463-468.
13. 　Dellinger EP, Tellado JM, Soto NE, et al. Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study[J]. Ann Surg, 2007, 245(5): 674-683.
14. 　Schietroma M, Carlei F, Lezoche E, et al. Acute biliary pancreatitis: staging and management[J]. Hepato-gastroenterology, 2001, 48(40): 988-993.
15. 　Kumar A, Singh N, Prakash S, et al. Early enteral nutrition in severe acute pancreatitis: a prospective randomized controlled trial comparing nasojejunal and nasogastric routes[J]. J Clin Gastroenterol, 2006, 40(5): 431-434.
16. 　Baril NB, Ralls PW, Wren SM, et al. Does an infected peripancreatic fluid collection or abscess mandate operation? [J]. Ann Surg, 2000, 231(3): 361-367.

West China Medical Journal

Effect of Total Enteral Nutrition Support on the Prognosis of Severe Acute Pancreatitis

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