The effects of nasogastric enteral nutrition on moderate-severe acute pancreatitis / 肠外与肠内营养

ABSTRACT

Objective:To explore the clinical efficacy,safety and tolerability of nasogastric enteral nutrition (NGEN) on moderate-severe acute pancreatitis (M-SAP).Methods:Sixty patients diagnosed as M-SAP and admitted admitted to Department of Gastroenterology,Affiliated Hospital of Southwest Medical University from November 2013 to August 2014 were randomized to receive enteral nutrition (EN) via a nasogasteic tube (n =30) or a nasojejunal tube (n=30).The intestinal permeability (endotoxin,D-lactic acid),inflammation index (CRP、IL-6、TNF-α),nutrition status,nutrition-related adverse effects (reflux aspiration,diarrhea and abdominal pain worse situation),condition assessment (APACHE Ⅱ and MCTSI),and prognosis (infection complications,mortality,length of hospital stay,hospital expenses)were collected and compared.Results:There was no statistically significant difference in the two groups as for intestinal permeability,inflammation index,evaluation of nutritional status,overall condition assessment,and prognosis (P ＞ 0.05).On the reflux aspiration,the rate of nasogastric tube enteral nutrition group (NG group) was 20％,nasojejunal enteral nutrition group (NJ group) was 3.3 ％,the difference was statistically significant (P ＜ 0.05).Conclusion:Either NGEN or NJEN has the similar effects on disease evolution,nutrition condition,intestinal permeability and prognosis of M-SAP.NGEN is simple and worthy of clinical attention.The nasogastric may more easily lead to reflux aspiration than the nasojejunal route.It requires more randomized controlled study to investigate its safety on SAP.