Effect Of Indirect Measurement Of Intra-Abdominal Pressure On The Timing Of Enteral Nutrition Inpatients With Severe Acute Pancreatitis

ObjectiveBy measuring the intravesical pressure in patients with severe acute pancreatitis,the method of indirect measurement of intra-abdominal pressure is used to determine the timing of enteral nutrition for patients with severe acute pancreatitis,so as to achieve the best effect of enteral nutrition,and choose enteral nutrition for patients with severe acute pancreatitis.The best time for nutrition provides a scientific basis.MethodsA total of 86 patients with severe acute pancreatitis who were admitted to the Department of Intensive Care Medicine(ICU)of the First Hospital of Qinhuangdao City,Hebei Province from January 2019 to July 2020 and met the inclusion and exclusion criteria were selected as the research subjects.They were randomly divided into experimental group and control group.The test group measured the intra-abdominal pressure indirectly by measuring the bladder pressure.When the bladder pressure was lower than 12mmHg,patients were given enteral nutrition;the control group was based on the patient’s serum amylase value,in which the serum amylase was 3 times lower than the normal maximum value(Start to give enteral nutrition when it is below 300U/L.Observe and record the C-reactive protein,white blood cell count,serum albumin,absolute value of lymphocytes before the start of enteral nutrition and the 7th day of enteral nutrition,the incidence of enteral nutrition feeding intolerance in the two groups,and the two groups of patients The number of days of hospitalization in the ICU was analyzed statistically.Measurement data were expressed as mean±standard deviation(X±S),using t test,P<0.05 indicated that the difference was statistically significant;counting data was expressed by rate and tested,P<0.05 indicates that the difference is statistically significant.Results1.General information of the two groups of patientsA total of 86 patients with severe acute pancreatitis,42 in the test group,44 in the control group,during the test,2 patients in the test group were transferred to the hospital,2 patients in the control group died,1 patient was transferred to the hospital,1 patient gave up treatment,the final test Group of 40 cases,including 24 males and 16 females,with an average age of 41.52±9.57 years old,including 15 cases of lipogenic pancreatitis,10 cases of biliary pancreatitis,10 cases of alcoholic pancreatitis,and 5 cases of idiopathic pancreatitis.Cases;control group:40 cases,26 males,14 females,with an average age of 41.75±9.79 years,including 13 cases of lipogenic pancreatitis,15 cases of biliary pancreatitis,9 cases of alcoholic pancreatitis,and idiopathic pancreas 3 cases of inflammation.There were no significant differences between the two groups of patients in terms of age,gender,disease type,and Acute Physiology and Chronic Health Evalution(APACHE Ⅱscore)(P>0.05).2.Laboratory indicators of the two groups of patientsThere was no significant difference in the absolute values of C-reactive protein,white blood cell count,serum albumin,and lymphocytes between the two groups before the start of enteral nutrition(P>0.05).On the 7th day of enteral nutrition,C-reactive protein in the two groups,The white blood cell counts all showed a downward trend,the absolute values of serum albumin and lymphocytes all increased,and the test group was better than the control group,the difference was statistically significant(P<0.05).3.Incidence of intolerance of enteral nutrition feeding in the two groupsThere were 3 cases of feeding intolerance in the experimental group,with an incidence rate of 7.5%,and 11 cases in the control group with feeding intolerance,with an incidence rate of 27.5%.The chi-square test showed that the difference was statistically significant(χ2=4.13,P<0.05)4.The time for the two groups of patients to stay in the ICUThe time of staying in the ICU of the experimental group(13.00±3.43d)was less than the time of staying in the ICU of the control group(19.63±4.90d).The t test showed that the difference was statistically significant(P<0.05).Conclusions1.Measurement of bladder pressure and indirect measurement of intra-abdominal pressure.Choosing the timing of enteral nutrition for patients with severe acute pancreatitis can better improve the patient’s nutritional indicators and immune function,and reduce the patient’s inflammatory response.2.Measurement of bladder pressure and indirect measurement of intra-abdominal pressure.Choosing the timing of enteral nutrition for patients with severe acute pancreatitis can reduce the incidence of feeding intolerance in the implementation of enteral nutrition.3.Measurement of bladder pressure and indirect measurement of intra-abdominal pressure.Choosing the timing of enteral nutrition for patients with severe acute pancreatitis can reduce the time for patients to stay in ICU,reduce medical expenses,and reduce the burden on patients.