Study on the treatment effect of early enteral nutrition on severe acute pancreatitis_West China Medical Journal

Authors：

LIANGGang , TANDong , HEMengguo , ZHANGTianzheng ,  DUANHongliang

Department of Hepatobiliary Surgery, No.215 Hospital of Shaanxi Nuclear Industry, Xianyang, Shaanxi 712000, P. R. China;

Corresponding author：

DUANHongliang, Email: duanhongliang180@qq.com

Keywords：

Severe acute pancreatitis; Enteral nutrition; Nutrition therapy

DOI：

10.7507/1002-0179.201512086

Video：

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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.

Citation： LIANGGang, TANDong, HEMengguo, ZHANGTianzheng, DUANHongliang. Study on the treatment effect of early enteral nutrition on severe acute pancreatitis. West China Medical Journal, 2017, 32(1): 8-11. doi: 10.7507/1002-0179.201512086 Copy

1.	费改顺. 急性胰腺炎营养支持研究进展. 西北国防医学杂志, 2015, 36(7): 462-465.
2.	Hynninen M, Vahonen M, Markkanen H, et al. Intramucosal pH and endotoxin and cytokine release in severe acute panereatitis. Shock, 2000, 13(1): 79.
3.	冷凯, 罗燕青, 曾鹏飞. 肠内营养支持治疗重症急性胰腺炎的临床研究. 中国普通外科杂志, 2014, 23(3): 392-395.
4.	中华医学会外科学分会胰腺外科学组. 急性胰腺炎诊治指南(2014). 中华普通外科学文献: 电子版, 2015, 14(2): 86-89.
5.	Brisinda G, Vanella S, Crocco A, et al. Severe acute pancreatitis: advances and insights in assessment of severity and management. Eur J Gastroenterol Hepatol, 2011, 23(7): 541-551.
6.	Mounzor R, Langmead CJ, Wu B, et al. Comparison of existing clinical scoring system to predict persistent organ failure in patients with actue pancreatitis. Gastroenterology, 2012, 142(7): 1476-1482.
7.	Raraty MG, Halloran CM, Dodd S, et al. Minimal access retroperitoneal pancreatic necrosectomy: improvement in morbidity and mortality with a less invasive approach. Ann Surg, 2010, 251(5): 787-793.
8.	李维勤. 重症急性胰腺炎早期肠内营养管支持治疗. 中国实用外科杂志, 2012, 32(7): 533-535.
9.	苗毅. 重症急性胰腺炎诊断及治疗的难点与争议. 中国实用外科杂志, 2012, 32(7): 520-522.
10.	Pezzilli R, Fantini L, Morselli-Labate AM. New approaches for the treatment of acute pancreatitis. JOP, 2006, 7(1): 79-91.
11.	Dervenis C. Enteral nutrition in severe acute pancreatitis: future development. JOP, 2004, 5(2): 60-63.
12.	Mirtallo JM, Forbes A, Mcclave SA, et al. International consensus guidelines for nutrition therapy in pancreatitis. J Parenter Enteral Nutr, 2012, 36(3): 284-291.
13.	温怡洪, 李国伟, 方海星. 早期肠内营养治疗对急性重症胰腺炎所致 SRIS 转归的影响. 中国普通外科杂志, 2015, 24(3): 446-448.
14.	石志敬. 肠内营养启动时机对重症急性胰腺炎预后影响的临床研究. 山西医科大学, 2009(21): 3633-3641.
15.	梁红亮, 杨曦, 陈旭平, 等. 经胃镜放置空肠营养管对急性重症胰腺炎的营养支持和预防感染价值. 华西医学, 2012, 27(11): 1617-1620.
16.	刘潇. 急性重症胰腺炎肠内场外营养的疗效对比. 临床急诊杂志, 2015, 16(6): 425-427.
17.	姚红兵, 曾荣城, 文明波, 等. 早期肠内营养与延迟肠内营养治疗重症急性胰腺炎的临床疗效比较. 实用医学杂志, 2014(14): 2231-2233.
18.	胡毅, 博涛, 高文彪. 早期肠内营养支持对重症急性胰腺炎患者炎症反应和免疫功能的影响.中国老年学杂志, 2015, 35(8): 2083-2084.
19.	付云辉, 文剑波, 王桂良, 等. 早期肠内营养对重症急性胰腺炎患者细胞因子水平及内毒素的影响. 世界华人消化杂志, 2015, 23(7): 1174-1179.
20.	Sun JK, Mu XW, Li WQ, et al. Effects of enteral nutrition on immune function of severe acute pancreatitis patients. World J Gastroenterol, 2013, 19(6): 917-922.

1. 费改顺. 急性胰腺炎营养支持研究进展. 西北国防医学杂志, 2015, 36(7): 462-465.
2. Hynninen M, Vahonen M, Markkanen H, et al. Intramucosal pH and endotoxin and cytokine release in severe acute panereatitis. Shock, 2000, 13(1): 79.
3. 冷凯, 罗燕青, 曾鹏飞. 肠内营养支持治疗重症急性胰腺炎的临床研究. 中国普通外科杂志, 2014, 23(3): 392-395.
4. 中华医学会外科学分会胰腺外科学组. 急性胰腺炎诊治指南(2014). 中华普通外科学文献: 电子版, 2015, 14(2): 86-89.
5. Brisinda G, Vanella S, Crocco A, et al. Severe acute pancreatitis: advances and insights in assessment of severity and management. Eur J Gastroenterol Hepatol, 2011, 23(7): 541-551.
6. Mounzor R, Langmead CJ, Wu B, et al. Comparison of existing clinical scoring system to predict persistent organ failure in patients with actue pancreatitis. Gastroenterology, 2012, 142(7): 1476-1482.
7. Raraty MG, Halloran CM, Dodd S, et al. Minimal access retroperitoneal pancreatic necrosectomy: improvement in morbidity and mortality with a less invasive approach. Ann Surg, 2010, 251(5): 787-793.
8. 李维勤. 重症急性胰腺炎早期肠内营养管支持治疗. 中国实用外科杂志, 2012, 32(7): 533-535.
9. 苗毅. 重症急性胰腺炎诊断及治疗的难点与争议. 中国实用外科杂志, 2012, 32(7): 520-522.
10. Pezzilli R, Fantini L, Morselli-Labate AM. New approaches for the treatment of acute pancreatitis. JOP, 2006, 7(1): 79-91.
11. Dervenis C. Enteral nutrition in severe acute pancreatitis: future development. JOP, 2004, 5(2): 60-63.
12. Mirtallo JM, Forbes A, Mcclave SA, et al. International consensus guidelines for nutrition therapy in pancreatitis. J Parenter Enteral Nutr, 2012, 36(3): 284-291.
13. 温怡洪, 李国伟, 方海星. 早期肠内营养治疗对急性重症胰腺炎所致 SRIS 转归的影响. 中国普通外科杂志, 2015, 24(3): 446-448.
14. 石志敬. 肠内营养启动时机对重症急性胰腺炎预后影响的临床研究. 山西医科大学, 2009(21): 3633-3641.
15. 梁红亮, 杨曦, 陈旭平, 等. 经胃镜放置空肠营养管对急性重症胰腺炎的营养支持和预防感染价值. 华西医学, 2012, 27(11): 1617-1620.
16. 刘潇. 急性重症胰腺炎肠内场外营养的疗效对比. 临床急诊杂志, 2015, 16(6): 425-427.
17. 姚红兵, 曾荣城, 文明波, 等. 早期肠内营养与延迟肠内营养治疗重症急性胰腺炎的临床疗效比较. 实用医学杂志, 2014(14): 2231-2233.
18. 胡毅, 博涛, 高文彪. 早期肠内营养支持对重症急性胰腺炎患者炎症反应和免疫功能的影响.中国老年学杂志, 2015, 35(8): 2083-2084.
19. 付云辉, 文剑波, 王桂良, 等. 早期肠内营养对重症急性胰腺炎患者细胞因子水平及内毒素的影响. 世界华人消化杂志, 2015, 23(7): 1174-1179.
20. Sun JK, Mu XW, Li WQ, et al. Effects of enteral nutrition on immune function of severe acute pancreatitis patients. World J Gastroenterol, 2013, 19(6): 917-922.

West China Medical Journal

Study on the treatment effect of early enteral nutrition on severe acute pancreatitis

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