[1]骆文君,李春花,林辉,等.营养支持在妊娠合并急性胰腺炎中的应用及疗效初步评价[J].第三军医大学学报,2017,39(13):1400-1403.
 LUO Wenjun,LI Chunhua,LIN Hui,et al.Application and preliminary evaluation of nutritional support in acute pancreatitis of pregnancy[J].J Third Mil Med Univ,2017,39(13):1400-1403.
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营养支持在妊娠合并急性胰腺炎中的应用及疗效初步评价(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
39卷
期数:
2017年第13期
页码:
1400-1403
栏目:
临床医学
出版日期:
2017-07-15

文章信息/Info

Title:
Application and preliminary evaluation of nutritional support in acute pancreatitis of pregnancy
作者:
骆文君李春花林辉郑媛钰
第三军医大学新桥医院消化内科
Author(s):
LUO Wenjun LI Chunhua LIN Hui ZHENG Yuanyu

Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China

关键词:
急性胰腺炎妊娠肠外营养肠内营养
Keywords:
acute pancreatitis pregnancy parenteral nutrition enteral nutrition
分类号:
R459.3; R576; R714.255
文献标志码:
A
摘要:

目的      评价营养支持在妊娠合并急性胰腺炎患者中的应用及其疗效。方法      以我科2013 年1 月至2016年6 月期间住院治疗的全部31例妊娠合并急性胰腺炎患者为研究对象,描述营养支持的应用,并比较肠外营养(parenteral nutrition,PN)与肠外营养联合肠内营养(enteral nutrition,EN)应用的临床效果。结果       妊娠合并轻症急性胰腺炎患者8例(25.81%)均未进行营养支持,妊娠合并中重症急性胰腺炎患者中,分别有32.26%(10/31)和41.94%(13/31)的患者采用PN、PN和EN联合进行营养支持。PN和EN联合营养支持治疗组的感染发生率(18.18%)、腹胀缓解时间(3.85±1.07)d、体温恢复正常时间(6.31±2.29)d、住院时间以及住院费用均显著低于PN支持治疗组(P<0.05),但不同营养支持方式治疗组间的胎儿终止妊娠率、早产率和足月生产率差异无统计学意义(P>0.05)。结论       在妊娠合并急性胰腺炎病例中,营养支持应用广泛;肠外营养与肠内营养联合营养支持总体临床效果优于肠外营养。

Abstract:

Objective      To investigate the application and evaluate the effects of different nutritional support therapies in the pregnant women with acute pancreatitis. Methods      Thirty-one pregnant women with acute pancreatitis admitted in our department from January 2012 to June 2016 were recruited in this study. The differences between the nutritional status of patients who accepted parenteral nutrition (PN) alone or combined parenteral and enteral nutrition (PN+EN) were described and evaluated for clinical efficacy. Results      There were 8 patients (8/31, 25.81%) with mild acute pancreatitis treated with no any nutritional support therapy. Ten of the 31 patients (10/31, 32.26%) with moderate pancreatitis were treated with PN alone, and the left 13 (13/31, 41.94%) were treated with PN+EN. The PN+EN group had an infection incidence of 18.18%, bradycardia duration of 3.85±1.07 d, and time of returning to normal temperature of 6.31±2.29 d. The length of hospital stay and the hospitalization costs were significantly lower in the PN+EN group than the PN group (P<0.05). However, there were no significant differences in the terminating pregnancy rate, preterm birth rate and term birth rate between the 2 groups (P>0.05). Conclusion      In the cases of acute pancreatitis in pregnancy, nutritional support should be widely applied. PN+EN is superior to PN alone in clinical practice.

参考文献/References:

[1]XU Q, WANG S, ZHANG Z. A 23-year, single-center, retrospective analysis of 36 cases of acute pancreatitis in pregnancy[J]. Int J Gynaecol Obstet, 2015, 130(2): 123-126. DOI:10.1016/j.ijgo.2015.02.034.
[2]GILBERT A, PATENAUDE V, ABENHAIM H A. Acute pancreatitis in pregnancy: a comparison of associated conditions, treatments and complications[J]. J Perinat Med, 2014, 42(5): 565-570. DOI:10.1515/jpm-2013-0322.
[3]IGBINOSA O, PODDAR S, PITCHUMONI C. Pregnancy associated pancreatitis revisited[J]. Clin Res Hepatol Gastroenterol, 2013, 37(2): 177-181. DOI:10.1016/j.clinre.2012.07.011.
[4]肖炳华,黄耿文,李宜雄,等.妊娠期急性胰腺炎:单中心20年52例分析[J]. 中国普通外科杂志,2014,23(3):297-300. DOI: 10.7659/j.issn.10056947.2014.03.006.
XIAO B H,  HUANG G W, LI Y X,et al.Acute pancreatitis during pregnancy:a 20-year singl-center experience of 52 cases[J]. Chin J Gen Sur, 2014,23(3):297-300. DOI: 10.7659/j.issn.10056947.2014. 03.006.
[5]PAPADAKIS E P, SARIGIANNI M, MIKHAILIDIS D P, et al. Acute pancreatitis in pregnancy: an overview[J]. Eur J Obstet Gynecol Reprod Biol, 2011, 159(2): 261-266. DOI:10. 1016/j.ejogrb.2011.07.037.
[6]贺芳,唐小林. 妊娠合并急性胰腺炎的研究进展[J].中华产科急救电子杂志,2016,5(1):55-57. DOI:103877/cma.j.issn. 20983259.2016 01.014.
HE F, TANG X L. Research progress of pregnancy complicated with acute pancreatitis[J].Chin J Obstet Emerg(Elec-Ed) ,2016,5(1):55-57. DOI: 103877/cma.j.issn.2098-3259.2016 01.014.
[7]FORSMARK C E, VEGS S S, WILCOX C M. Acute Pancreatitis[J]. N Engl J Med,2016,375:1972-1981. DOI:10.1056/ NEJMral505202.
[8]王兴鹏,李兆申,袁耀宗,等. 中国急性胰腺炎诊治指南(2013,上海)[J].中华胰腺病杂志, 2013, 13(2):73-78. DOI:10.3969/j.issn.1008-7125.2013.07.010.
WANG X P, LI Z S, YUAN Y Z,et al.  Guidelines for diagnosis and treatment of acute pancreatitis in China (2013, Shanghai)[J]. Chin J Pancreatol, 2013, 13(2):73-78. DOI:10.3969/j.issn. 10087125.2013.07.010.
[9]MIRTALLO J M, FORBES A, MCCLAVE S A, et al. International consensus guidelines for nutrition therapy in pancreatitis[J]. J Parenter Enteral Nutr, 2012, 36(3): 284-291. DOI:10.1177/0148607112440823.
[10]YI F, GE L, ZHAO J, et al. Metaanalysis: total parenteral nutrition versus total enteral nutrition in predicted severe acute pancreatitis[J]. Intern Med, 2012, 51(6): 523-530. DOI:10.2169/internalmedicine.51.6685.
[11]LODEWIJKX P J, BESSELINK M G, WITTEMAN B J, et al. Nutrition in acute pancreatitis: a critical review[J]. Expert Rev Gastroenterol Hepatol, 2016, 10(5): 571-580. DOI:10. 1586/17474124.2016.1141048.
[12]MCCLAVE S A, CHANG W K, DHALIWAL R, et al. Nutrition support in acute pancreatitis: a systematic review of the literature[J]. JPEN J Parenter Enteral Nutr, 2006, 30(2): 143-156. DOI:10.1177/0148607106030002143.
[13]HATA T, SAKATA N, OKADA T, et al. Dilated papilla with mucin extrusion is a potential predictor of acute pancreatitis associated with intraductal papillary mucinous neoplasms of pancreas[J]. Pancreatology, 2013, 13(6): 615-620. DOI:10.1016/j.pan.2013.09.003.
[14]杨绪兰,罗莉,余友敏, 等.TPN 和EN 对急性胰腺炎患者肠屏障和免疫功能的影响[J]. 西南国防医药,2016, 26(6):584-586. DOI: 10.3969/j.issn.10040188.2016.06. 002.
YANG X L, LUO L, YU Y M,et al. Effects of TPN and EN on intestinal barrier and immune function in patients with acute pancreatitis[J]. Med J Nati Defending Forces Southwest China, 2016, 26(6):584-586. DOI:10.3969/j.issn.10040188.2016.06.002.
[15]夏龙,胡文秀,欧阳晓晖.肠外营养与肠内营养结合治疗重症急性胰腺炎的体会(附200 例报道).中国普外基础与临床杂志,2016,23(4):439-444. DOI:10.7507/10079424. 20160116.
XIA L, HU W X, OUYANG X H. Parenteral nutrition and enteral nutrition combined with the experience of treatment of severe acute pancreatitis with 200 cases report[J]. Chin J Bases Clin General Surg, 2016,23(4):439-444. DOI:10.7507/10079424.20160116.
[16]JIN J, YU Y H, ZHONG M, et al. Analyzing and identifying risk factors for acute pancreatitis with different etiologies in pregnancy[J]. J Matern Fetal Neonatal Med, 2015, 28(3): 267-271. DOI:10.3109/14767058.2014. 913132.
[17]TAO Y, TANG C, FENG W,et al.Early nasogastric feeding versus parenteral nutrition in severe acute pancreatitis: A retrospective study[J]. Pak J Med Sci, 2016 ,32(6):1517-1521. DOI: 10.12669/pjms.326.11278.
[18]ZHU Y, YIN H, ZHANG R,et al.Nasogastric nutrition versus nasojejunal nutrition in patients with severe acute pancreatitis: a metaanalysis of randomized controlled trials[J].Gastroenterol Res Pract, 2016,2016: 6430632. DOI: 10.1155/2016/6430632.
[19]DAI Y J, SUN L L, LI M Y, et al. Comparison of formulas based on lipid emulsions of olive oil, soybean oil, or several oils for parenteral nutrition: a systematic review and metaanalysis[J]. Adv Nutr, 2016, 7(2): 279-286. DOI: 10.3945/an.114.007427.

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更新日期/Last Update: 2017-07-14