Comparative effects of early and delayed enteral nutrition on intestinal function recovery in patients with severe acute pancreatitis
早期肠内营养与延迟肠内营养在重症急性胰腺炎患者肠道功能恢复中的效果对比

摘要

目的 探讨重症监护室早期肠内营养（EEN）与延迟肠内营养（DEN）在重症急性胰腺炎（SAP）患者肠道功能恢复中的效果差异。方法 选取34例SAP患者，随机分为早期肠内营养组（EEN组，n=17）和延迟肠内营养组（DEN组，n=17），两组患者均接受监护治疗并达到营养支持标准，通过比较两组患者的症状缓解时间、血、尿淀粉酶恢复时间等指标评价肠道功能恢复效果。症状缓解时间通过C反应蛋白（CRP）水平和住院天数衡量，血、尿淀粉酶恢复时间则直接测量相关指标的变化。结果 EEN组患者CRP显著低于DEN组；EEN组住院天数明显少于DEN组，EEN组患者的血淀粉酶恢复时间显著快于DEN组；尿淀粉酶的恢复时间亦优于DEN组。结论 早期肠内营养对于重症急性胰腺炎患者的症状缓解及肠道功能恢复具有显著提升作用，相较于延迟肠内营养，可有效减轻炎症反应，缩短住院时间和淀粉酶恢复时间，值得临床推广应用。

Abstract

Objective To investigate the differences in the effects of early enteral nutrition(EN)and delayed parenteral nutrition(PN)on intestinal function recovery in patients with severe acute pancreatitis(SAP)in the intensive care unit.
Methods A total of 34 patients with SAP were randomly divided into the early enteral nutrition group (EN group, n=17) and the delayed parenteral nutrition group (PN group, n=17). Both groups received monitoring and treatment and met the criteria for nutritional support. The recovery of intestinal function was evaluated by comparing the time to symptom relief, the recovery time of blood and urine amylase levels, and other indicators between the two groups. The time to symptom relief was measured by C-reactive protein (CRP)levels and the number of hospitalization days, while the recovery time of blood and urine amylase was directly measured by changes in the relevant indicators.
Results Patients in the EN group had significantly lower CRP levels than those in the PN group. The EN group had a shorter hospital stay and a faster recovery time for blood amylase levels compared to the PN group. The recovery time for urine amylase was also better in the EN group than in the PN group.
Conclusion   Early enteral nutrition significantly improves symptom relief and intestinal function recovery in patients with severe acute pancreatitis. Compared with delayed parenteral nutrition, it can effectively reduce the inflammatory response, shorten the hospital stay and the recovery time of amylase levels, and is worthy of clinical promotion and application.