目的 观察早期肠内营养(EN)联合清胰汤肠内滴注治疗急性重症胰腺炎的疗效.方法 41例急性重症胰腺炎患者分为观察组22例和对照组19例,对照组患者给予全胃肠外营养,观察组患者给予早期EN联合清胰汤肠内滴注,观察比较2组患者白细胞和血淀粉酶恢复正常的时间、住院时间、并发症、病死率及临床疗效.结果 2组治疗前急性生理及慢性健康状况评分系统(APACHEⅡ)评分比较差异无统计学意义(P＞0.05).对照组治疗前、后APACHEⅡ评分比较差异无统计学意义(P＞0.05)；观察组治疗24h APACHEⅡ评分与治疗前比较差异无统计学意义(P＞0.05),但治疗48、72 h APACHEⅡ评分显著低于治疗前(P＜0.05).2组治疗24 h APACHEⅡ评分比较差异无统计学意义(P ＞0.05)；治疗48和72 h观察组APACHEⅡ评分显著低于对照组(P＜0.05).观察组患者病死率及并发症发生率显著低于对照组(P＜0.05).观察组患者白细胞和血淀粉酶恢复正常时间及住院时间均显著短于对照组(P＜0.05).结论 早期EN联合清胰汤肠内滴注治疗急性重症胰腺炎疗效确切,并发症少,病死率低,住院时间短.%Objective To investigate the effect of early enteral nutrition combined with Qingyitang enteral infusion on patients with acute severe pancreatitis. Methods Forty-one patients with acute severe pancreatitis were divided into observation group and control group,nineteen patients in control group were treated with total parenteral nutrition,twenty-two patients in observation group were treated with early EN and Qingyitang enteral infusion. The recovery time of leucocyte and amylase, hospital stay, complication, case fatality and clinical effect were observed and compared. Results There was no significant difference in APACHE II scores between two groups before treatment (P > 0.05), There was no significant difference in APACHE II scores in control group before and after treatment (P < 0.05 ). In observation group, there was no significant difference in APACHE H scores before and after twenty-four hours treatment (P > 0.05 ) , but the APACHE Ⅱ scores after forty-eight and seventy-two hours treatment were significantly lower than those before treatment ( P < 0. 05). There was no significant difference in APACHE H scores between two groups after twenty-four hours treatment (P > 0.05). The APACHE Ⅱ scores in observation group were significantly lower than those in control group after forty-eight and seventy-two hours treatment (P < 0. 05). The case fatality and complication incidence in observation group were significantly lower than those in control group ( P<0.05). The time of leucocyte and hemodiastase returned to normal and hospital stay in observation group was significantly shorter than that in control group (P <0.05). Conclusion Early EN combined with Qingyitang enteral infusion on patients with acute severe pancreatitis can obtain godd effect by reducing complication and case fatality and shortening hospital stay.
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