Comparative Clinical Study Of Severe Acute Pancreatitis Early Enteral And Parenteral Nutrition

Objectives: To compare the clinical outcomes from Enteral nutrition VS parenteral nutrition with severe acute pancreatitis (SAP), and discuss the advantages and disadvantages between them.Methods:1. We searched the clinical outcomes from the 3 area of Hepatopancreatobiliary Surgery Department of The second affiliated hospital of Kumming Medical University, from Oct.2010 to Oct.2014 with the hospital course data on the use of enteral nutrition in the management of SAP patients coverage from the age 24 to age 87.2. Firstly, collection the patients’ information and relevant based date, and analysis those clinical outcomes, Laboratory report, image data for APACHE Ⅱ& Ranson assess, to records the rate of complications, the length of hospital stay, hospitalization expenses, etc.3. We included 75 severe acute pancreatitis (SAP) patients in this research,44 male and 31 female were randomized into 3 groups as:Enteral nutrition group (EN), Traditional Parenteral nutrition group+Enteral nutrition group (PN+EN), Traditional Parenteral nutrition group group (TPN). This systematic review was carried out to analyses statistical process data to compare with the clinical effects, the blood biochemical indexes, the rate of complications, the conditions of prognosis, the length of hospital stay and hospitalization expenses difference in EN:PN+EN:TPN for severe acute pancreatitis (SAP).Results:There were significant differences in the rank-sum test for pretherapy and post-treatment within EN, PN+EN, TPN 3 groups. Lipase, hemodiastase, total histones, albumin, prealbumin (PAB), serum calcium, white blood cell count all have statistically significant difference.From T-test results to compare pretherapy VS post-treatment for those 3 groups, the results shows on APACHEII, Ranson, SOFA assess for pretherapy were significantly differences. But for post-treatment data analyses the APACHEII, Ranson, SOFA assess without statistically significant difference.However, the multi-organ failure (MOF),ARDS and Renal insufficiency in the results of this research as with too low patient number, cannot be compared, no statistical significance for all 3 groups.From the variance analysis for 3 groups showed that:length of hospital stay with statistically significance differences (F=32.233, p<0.001), furthermore, a statistical significance in the 3 groups also on hospitalization expenses (F=150.497, p<0.001).Conclusion:1. For patients with severe acute pancreatitis, recommend enteral nutrition as early as possible, early nasal jejunal enteral nutrition is safe feasible and efficient.2. Comparing with the parenteral nutrition, early enteral nutrition can improve patient serum total protein, albumin, prealbumin levels.3. Comparing with the parenteral nutrition, early enteral nutrition can also reduce the intestinal infection, systemic inflammatory response syndrome (SIRS), multiple organ dysfunction syndrome (MODS) and other complications.4. Enteral nutrition therapy in SAP may shorten hospital stay and reduced hospital costs than parenteral nutrition also. Reasonable early enteral nutrition in severe acute pancreatitis might help to improving the conditions of the body’s nutritional status and immunity, it is strongly suggest to promoting in clinical application.