To Observe The Efficacy Of Enteral Nutrition In The Treatment Of Severe Acute Pancreatitis In Early Stage

Objective:To collect clinical cases, observe the effects of different ways of nutrition therapy for patients with severe acute illness recovery and prognosis brought, respectively, to explore and evaluate the use of early enteral nutrition and use of parenteral nutrition Then smooth transition patients with severe acute pancreatitis enteral nutrition therapy in two of nutrition, its effect of differences in disease recovery.Methods:Buyers cases, retrospective analysis of three years(January 2012-December 2014) 64 cases have been in the top three from general hospital for treatment of severe acute pancreatitis patients, all patients receiving nutritional support in accordance with the way points into two groups, namely: early enteral nutrition group(EEN group), a total of 32 cases, which divided by gender: 19 males and 13 females, according to the predisposing factors are divided into: 12 cases of biliary, alcoholic four cases, overeating nine cases,seven cases of unknown cause. Joint Parenteral and Enteral Nutrition group(PN+EN group), a total of 32 cases, divided by gender: 17 males and 15 females, divided according to etiology: 14 cases of biliary after overeating caused nine cases, alcohol of the three cases,6 cases of unknown causes. Comparison of the collection of income homes and were used early enteral nutrition and parenteral nutrition then use to support the smooth transition of relevant laboratory tests after 14 days of enteral nutrition in two indicators of nutrition,including: blood amylase(AMS), serum albumin(ALB), C-reactive protein(CRP), white blood cell count(WBC), serum calcium level, aspartate aminotransferase(AST) andalanine aminotransferase(ALT). Comparison of the three groups before and after nutritional support APACHEII, SOFA score and Marshall scores improved, more complications, pancreas secondary to infection, and the average length of stay.Results:After 14 days of clinical treatment, the use of early admission which adopts the enteral nutritional support, serum albumin(ALB) 39.67±7.82(g/L), C-reactive protein(CRP) 23.22±8.51(mg/L), white blood cell count(WBC) 7.21±1.16, serum calcium levels2.23±0.14(mmol/L),aspartate aminotransferase(AST) 48.3±18.7(U/L) and alanine aminotransferase(ALT) 47.2±17.7(U/L), compared with the early use of parenteral nutrition and then a smooth transition for patients enteral nutrition were significantly improved(P<0.05); Acute Physiology and Chronic Health EEN group score(APACHEII score) 7.45±1.68, SOFA score 2.39±1.06 and 0.84±0.69 Modified Marshall scores compared PN+EN group improved significantly(P<0.05); two prognostic indicators compare EEN group recovery time at body temperature 6.9±1.4(d), secondary infection 6(18.8%) incidence of complications 11(34.4%) and the average length of stay 19.7±2.2(d)respects substantially reduced, the advantage is clear(P <0.05).Conclusion:The use of parenteral nutrition with early and then effect a smooth transition for the restoration of enteral nutrition compared to the patients in the early stage can effectively maintain the use of enteral nutrition in severe acute pancreatitis patients with intestinal mucosal barrier function, inhibit bacterial translocation and reduces release of inflammatory cytokines, immune function is maintained at an effective level, significantly prevent the development of disease progression and reduce the possibility of secondary infection, the clinical treatment of severe acute pancreatitis should be promoted.