The application and research of enteral nutritional support in patients with acute severe pancreatitis

Abstract

Objective To observe the effect of enteral nutrition(EN) in thetreatment of patients with acute severe pancreatitis and to study its applying time,ways as well as the choice of EN preparation. Methods 40 cases of acute severe pancreatitis were collected according to diagnostic standard in the Atlanta international meeting,these patients were divided into two groups on the basis of stochastics in which was given TEN and TPN support separately.The supply of total heat,the time of beginning and supporting days are same in this two groups.Catheter from nose to intestine which was provided by UNTRICIA copany has been applied in the TEN group,the tip of catheter should be up to below of Treitz ligament.The use of EN preparation-Nutrison Fibre,Pepti-2000 and Elental were occupied 1/3 respectively in TEN group.The serum albumin,prealbumin,transferring,IgG,IgM,IgA,liver function and blood as well as urinary amylase in all patients were monitored,meanwhile CT follow-up examination was taken regularly.The data from above methods were proceeded to count and to analyze under SPSS 8.0 computer soft,at same time,the data were also tested by χ２ analysis TEST or T analysis. Results The concentration of serum albumin in patients of two groups apparently was increased before obtaining the EN support,but there is not apparently difference between two groups.The level of albumin()in TEN group was clearly increased compare with that in TPN group after the ten days getting EN support,the apparently differences were seen through comparing two groups's patients.The recovery of liver function in TEN group were obvious more than that in TPN group.There is no obvious difference in the aspect of amylase'dropping and CT pictures in two groups.For these patients getting full EN support,the opportunity affecting complication of stomach and intestinal tract as well as metabolism were less,and the patient is easy to accept it. Conclusions Early EN support in patients with acute severe pancreatitis not only is important but also feasible.EN has apparent advantage compare with PN in the aspect of increasing the synthesis of rapidly reactive albumen,improving liver function and immunity function,mitigating the acute reaction and enhancing the function of intestinal tract's mucous as barrier,reducing TPN complication.