| Background and ObjectivesAcute pancreatitis(AP)is an inflammatory disease of pancreatic tissue caused by one or more causes.In China,the most common cause of AP is gallstone,with severe acute pancreatitis being critically ill,prone to multiple organ failure such as respiration,circulation,kidneys,pancreatic necrosis,abscess,and pseudocyst Formation usually leads to high mortality?Nutritional support plays an important role in SAP management due to increased demand and increased risk of malnutrition in patients with reduced food intake and associated inflammatory diseases.Nutritional support therapy for pancreatitis is an important means to prevent necrotising secondary infections and improve prognosis.The best nutritional support for acute pancreatitis has been a topic of debate for decades.Initially,it was thought that pancreatic rest through fasting could improve the prognosis.Subsequently,intestinal nutritional support is thought to avoid pancreatic stimulation and provide the necessary nutrients,but clinical beds and experimental evidence show that the local and systemic inflammatory media of complete intestinal nutrition is on average higher than intestinal nutrition.Since the mid-1990s,many experiments on intestinal nutrition have shown the benefits of intestinal nutrition.At present,it is generally believed that feeding by nasal empty intestinal tube can avoid stimulation of the pancreas,so the nasal empty intestinal nutrition is currently commonly used intestinal nutrition support methods.However,the medical conditions in primary hospitals are limited and the guidance of clinical nutrition physicians is lacking,which limits the application of enteral nutrition through the nasal jejunum.With the in-depth study of SAP,it was found that patients with SAP lost most of their exocrine function due to pancreatic damage,especially the significant reduction of cholecystokinin,and the current application of drugs that inhibit pancreatic juice secretion,it was considered that the nasogastric tube nutrition approach was feasible.In recent years,clinically found that nutrition through the nasal gastric tube does not aggravate the disease.The purpose of this study is to compare the advantages and disadvantages of the two nutritional methods from multiple angles,and to clarify the application value of the nutritional methods in the nasal gastric tube intestine.Materials and MethodsFrom September 2016 to November 2019,60 patients were diagnosed with SAP parallel intestinal nutrition support treatment at The Second Affiliated Hospital of Zhengzhou University,including 40 cases of men and 20 cases of females,and were randomly divided into nasal gastric tube group(30 cases in NG group and 30 cases in the nasal and empty intestinal tube group(30 cases in nJ group).The levels of C-reactive protein,leukin-6(IL-6)and calcium-lowering(PCT)were compared in two groups of different time points,the levels of albumin and pre-albumin were compared in two groups,the recovery time of blood amylase,urinary amylase and lipase in two groups of patients was observed,and the recovery time of intestinal resounding was compared.Exhaust defecation recovery time,bloating relief time,oral feeding time,observation and comparison of immune function indicators in two groups of patients,observation and comparison of two groups of intestinal mucosa barrier function indicators,observation and comparison of nutritional support related complications of two groups of patients,observation and comparison of two groups of APACHE score and AGI score,observation and comparison of two groups of patients prognosis.The SPSS 24.0 analysis software was used for statistical analysis.Results(1)There was no significant difference in CRP,IL-6,and PCT levels between the two groups before treatment,7 days after treatment,and 14 days after treatment(P>0.05).The levels of CRP at 7 days and 14 days after treatment were significantly lower than those before treatment.The PCT levels at day 14 and 14 days after treatment were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).Between the two groups,7 days after admission and 14 days after admission,the difference was not statistically significant(P>0.05),the albumin level of the two groups was significantly higher than the albumin level at the time of admission,and the albumin level was significantly higher than the albumin level at the time of admission 7 days after admission and 14 days after admission(P<0.05).(2)There was no significant difference in the albumin and prealbumin levels between the two groups before treatment,7 days after treatment,and 14 days after treatment(P>0.05).The levels of albumin at 7 days and 14 days after treatment were significant It was higher than the pre-treatment albumin level.The albumin level before 7 days and 14 days before treatment were significantly higher than the pre-treatment albumin level,and the difference was statistically significant(P<0.05).(3)There was no significant difference in blood amylase,urine amylase,and lipase recovery time between the two groups(P>0.05).(4)There was no significant difference in bowel sound recovery time,exhaust time,and bloating relief time between the two groups(P>0.05);however,the oral feeding time of the NG group was shorter than that of the NJ group,and the differences were statistically significant(P<0.05).The AGI grade of 7 days after admission and 14 days after admission were lower than the AGI grade before admission,but there was no significant difference in AGI grade between the two groups at the same time(P>0.05).(5)There was no significant difference in the incidence of abdominal distension,incidence of diarrhea,incidence of vomiting,reflux,incidence of aspiration,and incidence of gastric retention between the two groups(P>0.05).(6)In 7 days after admission and 14 days after admission,the APACHE ? scores of the two groups were lower than the APACHE ? scores at admission,and the difference was statistically significant(P<0.05).There was no significant difference in APACHE ? score between the two groups at the same time(P>0.05).(7)There was no significant difference in the incidence of pancreatic infection,the incidence of MODS,mortality,surgical intervention rate,and length of hospital stay between the two groups(P>0.05);the hospitalization cost of the NG group was lower than that of the NJ group,and the difference was statistically significant.(P<0.05).Conclusions(1)Nasogastric enteral nutrition and nasojejunal enteral nutrition play equal roles in improving the nutritional status,inflammation control level and prognosis of SAP patients,and deserve clinical attention;(2)The hospitalization cost of enteral nutrition via nasal gastrointestinal tube is less than that of enteral nutrition via nasal jejunal tube,which can reduce the economic burden of SAP patients and has clinical promotion value. |
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