Objective To explore the clinical value of early enteral nutrition in severe acute pancreatitis (SAP) by percutaneous endoscopic gastrostomy/jejunostomy (PEG/J).
Methods Treatment condition of nighty patients with SAP were retrospectively analysed.The 90 patients were collected peripheral venous blood respectively on 1, 12, and 18 d after admission to hospital.Forty-five of them were in PEG/J group, the others were in control group. Serum IL-6,TNF-α and endotoxin were detected by enzyme-linked immunosorbent assay (ELISA),CD4 /CD8 was determinated by indirect immunofluorescence staining method (FITC-labeled).
Results On 12 d and 18 d,the levels of serum IL-6, TNF-α, and endotoxin in PEG/J group were lower than those in control group (P<0.01).The CD4 /CD8 was significantly higher than that in control group (P<0.01).In control group, 2 cases complicated upper gastrointestinal haemorrhage,4 cases complicated pancreatic pseudocysts, and 2 cases complicated double infection, the temperature became normal after about 13.5 d.In PEG/J group, there were not upper gastrointestinal haemorrhage and double infection,but 2 cases also complicated pancreatic pseudocysts, the temperature became normal after about 10.5 d.
Conclusion The clinical effectiveness of early enteral nutrition in SAP by PEG/J is satisfactory.
Citation:
LIU Guohui,LIU Hongying,CHEN Gong,DU Xiaohong.. Clinical Effect of Early Enteral Nutrition in Severe Acute Pancreatitis by Percutaneous Endoscopic Gastrostomy/Jejunostomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(3): 310-313. doi:
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黄晓曦, 王兴鹏. 肠屏障功能障碍在重症急性胰腺炎中的作用 [J]. 临床内科杂志, 2007, 24(2): 79-81.
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邬淑雁, 李森龙, 刘昭慧, 等. 重症急性胰腺炎早期个体化肠内营养的临床研究 [J]. 山东医药, 2010, 50(40): 76-77.
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|
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童智慧, 李维勤, 虞文魁, 等. 重症急性胰腺炎病人在X 线及内镜辅助下放置鼻空肠管的比较 [J]. 肠外与肠内营养,2007, 14(3): 153-156.
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Windsor AC, Kanwar S, Li AG, et al. Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis [J]. Gut, 1998,42(3): 431-435.
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- 1. Cavaillon JM, Adib-Conquy M, Fitting C, et al. Cytokine cascade in sepsis [J]. Scand J Infect Dis, 2003, 35(9): 535-544.
- 2. 季占峰, 李月华, 张红霞, 等. 早期要素肠内营养与肠外、肠内阶段性营养治疗急性重症胰腺炎的对比研究 [J]. 实用医学杂志, 2010, 26(4): 581-583.
- 3. 刘震, 方向, 程若川, 等. 肠内、外营养支持治疗重症急性胰腺炎的临床疗效对比研究 [J]. 中国普外基础与临床杂志,2008, 15(7): 523-525.
- 4. 孙欣, 林方才, 苗迎春. 谷氨酰胺联合肠内营养对短肠综合征大鼠模型结肠黏膜的影响 [J]. 实用医学杂志, 2009,25(1): 43-44.
- 5. 白黎智, 康利民, 路小光, 等. 肠内免疫微生态营养对重症急性胰腺炎全身炎性反应及预后的影响 [J]. 中国医师进修杂志, 2010, 33(8): 14-17.
- 6. 中华医学会外科学分会胰腺外科学组. 重症急性胰腺炎诊治指南 [J]. 中华外科杂志, 2007, 45(11): 727-729.
- 7. 汪志明, 任建安, 江志伟, 等. 经皮内镜下胃造口空肠置管术在肠外瘘病人的应用 [J]. 肠外与肠内营养, 2009, 16(1):35-36, 39.
- 8. 谢颖, 朱维铭, 李宁, 等. 克罗恩病并发不全性肠梗阻的肠内营养治疗 [J]. 中华胃肠外科杂志, 2010, 13(12): 891-894.
- 9. 左利平, 董蕾, 朱建伟. 酪酪酞对急性胰腺炎细菌易位的影响 [J]. 陕西医学杂志, 2007, 36(10): 1279-1281.
- 10. 严强, 倪俊, 张国雷, 等. 过度肠内营养对家兔重症急性胰腺炎血液流变学及炎症因子的影响 [J]. 中华医学杂志, 2011,91(28): 2006-2010.
- 11. Sakorafas GH, Tsiotou AG. Etiology and pathogenesis of acute panereatitis:current concepts [J]. J Clin Gastroenterol, 2000,30(4):343-356.
- 12. 姚欣敏, 刘牧, 李云涛, 等. 早期反复间断血滤治疗重症急性胰腺炎的临床研究 [J]. 中国普外基础与临床杂志, 2008,15(5): 352-357, 361.
- 13. Carnovale A, Rabitti PG, Manes G, et al. Mortality in acute pancreatitis: is it an early or a late event [J]. JOP, 2005, 6(5):438-444.
- 14. Bhatia M. Inflammatory response on the pancreatic acinar cell injury [J]. Scand J Surg, 2005, 94(2): 97-102.
- 15. 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.
- 16. 黄晓曦, 王兴鹏. 肠屏障功能障碍在重症急性胰腺炎中的作用 [J]. 临床内科杂志, 2007, 24(2): 79-81.
- 17. 秦环龙, 苏振东, 胡雷光, 等. 早期肠内营养对犬重症急性胰腺炎自然病程和肠道屏障功能的影响 [J]. 中国普外基础与临床杂志, 2002, 9(5): 325-328.
- 18. 邬淑雁, 李森龙, 刘昭慧, 等. 重症急性胰腺炎早期个体化肠内营养的临床研究 [J]. 山东医药, 2010, 50(40): 76-77.
- 19. 董亮, 康焰. 早期肠内营养在重症急性胰腺炎治疗中的应用 [J]. 中国普外基础与临床杂志, 2008, 15(8): 567-571.
- 20. 童智慧, 李维勤, 虞文魁, 等. 重症急性胰腺炎病人在X 线及内镜辅助下放置鼻空肠管的比较 [J]. 肠外与肠内营养,2007, 14(3): 153-156.
- 21. Kalfarentzos FJ, Mead N. Enteral nutrition is superior to parenteral nutrition in severe acute pancreatitis:results of a randomized prospective trial [J]. Br J Surg, 1997, 84(12):1665.
- 22. Windsor AC, Kanwar S, Li AG, et al. Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis [J]. Gut, 1998,42(3): 431-435.