Clinical value of enteral nutrition via a nasojejunal feeding tube placed endoscopically and total parenteral nutrition in acute severe pancreatitis

Abstract

Objective To analyze clinical value of enteral nutrition via a nasojejunal feeding tube placed endoscopically and total parenteral nutrition in severe acute pancreatitis（SAP） .Methods 35 patients with SAP were received nasojejunal enteral nutrition endoscopically（NENE）,while other 35 patients were received total parenteral nutrition（TPN）.After nutrtion support for 4 weeks the nutrition index,Ranson score,APACHE score and CT score and complications and mortality rate of occurrence between the two groups were compared.Results After nutrition support of 4 weeks,the levels of hemoglobin and serum albumin of NENE group were （108 ±21） g/L,（38.7 ±9.5） g/L, which were significantly higher than those of TPN group（t=3.928,3.684,all P〈0.05）,while the fasting blood glucose of（5.1 ±1.2）mmol/L was significantly lower than that of TPN group（P〈0.05）,the level of CRP,TNF-α, IL-1 and IL-6 in patients of NENE group were （32.1 ±12.3）mg/L,（34.4 ±12.3）ng/L,（22.4 ±11.3）ng/L, （32.4 ±11.3）ng/L,which were significantly lower than those of TNP group（t=3.927,4.925,4.258,4.825,all P〈0.05）;the incidence of multiple organ dysfunction,hyperglycemia of NENE group were 17.14%,8.57%,5.71%, 5.71%,which were significantly lower than those of TPN group（χ^2 =4.167,4.529,5.082,4.926,all P〈0.05）. Conclusion Nasojejunal enteral nutrition endoscopically is safe in clinical application.Compared with TPN,NENE results in better control of the incidence of complication, and decreased the length of stay in hospital and the cost enteral nutrition were more beneficial than total parenteral nutrition. Key words: Severe acute pancreatitis; Enteral nutrition; Parenteral nutrition