Objective To explore the effect of early enteral nutrition in the clinical treatment of severe acute pancreatitis (SAP). Methods Forty-two SAP patients who improved with non-surgical treatments between January 2012 and December 2014 were selected and randomly divided into control group and study group with 21 patients in each. Patients in the control group accepted whole venous nutrition, while those in the study group had early enteral nutrition. Nutrition indexes, blood biological indexes, and Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score on day 7 and 14 after treatment, and average hospital stay of the two groups of patients were recorded and compared. Results No differences in body weight reduction, lymphocytes, serum albumin, calcium, glucose, APACHE Ⅱ score between the two groups after 7 days of treatment were observed (P>0.05). But there were significant differences in body weight, lymphocytes, serum albumin, and APACHE Ⅱ score between these two groups after 14 days of treatment (P<0.05). Hospital stay of the study group was obviously shorter (P<0.01). Conclusions Early enteral nutrition support for patients with severe acute pancreatitis can improve nutritional status and shorten hospital stay. It is worthy of wider clinical application.
ObjectiveTo investigate impact of splenectomy plus pericardial devascularization on liver hemodynamics and liver function for liver cirrhosis patients with portal hypertension. MethodsThe internal diameter, maximum velocity, minimum velocity, mean velocity, and flow volume of portal vein and hepatic artery of 42 cases of liver cirrhosis with portal hypertension were measured by Doppler ultrasonic instrument on day 1 before operation and on day 7 after operation. The free portal pressures at different phases (after open abdomen, after splenic artery ligation, after splenectomy, and after devasculanrization) were read from the disposable pressure sensor. Twenty-four healthy people through physical examination were selected as control. Results① The free portal pressure of liver cirrhosis patients with portal hypertension was decreased from (29.12±1.40) mm Hg after open abdomen to (22.71±1.21) mm Hg after splenic artery ligation, and further decreased to (21.32±1.12) mm Hg after splenectomy, but increased to (22.42±1.15) mm Hg after devasculanrization, the difference was statisticly different (all P < 0.01). ② Compared with the healthy people, for the liver cirrhosis patients with portal hypertension, the internal diameter, maximum velocity, minimum velocity, and flow volume of portal vein were significantly enlarged (all P < 0.01), which of hepatic artery were significantly reduced (all P < 0.01) on day 1 before operation; On day 7 after operation, the internal diameter of portal vein was significantly reduced (P < 0.01), the maximum velocity, minimum velocity, and mean velocity of portal vein were significantly enlarged (all P < 0.01), but the internal diameter of hepatic artery was significantly reduced (P < 0.01), the maximum velocity, minimum velocity, mean velocity, and flow volume of hepatic artery were significantly enlarged (all P < 0.01). For the liver cirrhosis patients with portal hypertension, compared with the values on day 1 before operation, the internal diameter and the flow volume of portal vein were significantly reduced (all P < 0.01) on day 7 after operation; the internal diameter, maximum velocity, minimum velocity, mean velocity, and flow volume of hepatic artery were significantly enlarged (all P < 0.01) on day 7 after operation. ③ The Child-Pugh classification of liver function between before and after surgery had no significant difference (χ2=1.050, P > 0.05). ④ No death and no hepatic encephalopathy occurred, no thrombosis of splenic vein or portal vein was observed on day 7 after surgery. Conclusionsplenectomy plus pericardial devascularization could decrease portal vein pressure and reduce blood flow of portal vein, while increase blood flow of hepatic artery, it doesn't affect liver function.