Application of beside manual placement of jejunal feeding tube in the treatment of severe acute pancreatitis / 中国基层医药

ABSTRACT

Objective To explore the clinical effect and safety of bedside hand jejunal nutrition tube placement in the treatment of severe acute pancreatitis. Methods The clinical data of 120 patients with severe acute pancreatitis treated in Dazhou Central Hospital from December 2014 to December 2016 were retrospectively analyzed. The patients in the control group(60 cases) were treated with nasogastric tube enteral nutrition on the basis of routine treatment. The patients in the observation group(60 cases) were treated with bedside bare hands on the basis of routine treatment, placement of jejunal feeding tube for jejunal nutrition treatment. The changes of gastrointestinal function,blood and urine amylase content,ICU stay time and the incidence of complications such as reflux and aspiration pneumonia were observed. Results In the observation group,the success rate was 96. 7％ (52 / 60),and the catheterization time was (23. 5 ± 8. 4)min,without any adverse reactions. The recovery time of bowel sounds and anal defecation time of the observation group were (2. 01 ± 0. 47)d and (2. 69 ± 0. 42)d,respectively,which were significantly shorter than those of the control group[(3. 63 ± 1. 52)d and (3. 96 ± 1. 36)d],and the differences were statistically significant(t = 7. 887, 6. 911,all P < 0. 01). There was no statistically significant difference in serum amylase level between the two groups before treatment(t = 1. 364,P > 0. 05). After treatment,the serum amylase level in the observation group was (163 ± 104)IU/ L,which was lower than that in the control group[(302 ± 136)IU/ L](t = 6. 289,P < 0. 01). The recovery time of urinary amylase and the stay time in ICU in the observation group were (9. 28 ± 1. 25)d,(11. 24 ± 0. 84)d, respectively,which were shorter than those in the control group[(16. 32 ± 3. 26) d,(18. 35 ± 2. 42) d],and the differences were statistically significant(t = 15. 619,21. 499,all P < 0. 01). Conclusion Enteral nutrition by beside manual placement of jejunal feeding tube in the treatment of patients with severe acute pancreatitis is simple and safe. It can effectively promote the recovery of intestinal function and shorten the time for ICU. It is worthy of application in clinical practice.