摘要
目的探讨重症急性胰腺炎(SAP)患者营养风险筛查与临床结局的关系,旨在为SAP的临床诊疗、预后判断等提供依据。方法选择2015年1月至2018年11月该院收治的SAP患者120例,于患者入院24 h内采用营养风险筛查2002(NRS-2002)对患者进行营养风险筛查,依据NRS-2002评分分组,NRS-2002评分大于或等于3分纳入A组(n=50),NRS-2002评分小于3分纳入B组(n=70)。两组患者均予以SAP的常规治疗措施。比较两组患者的血淀粉酶、血清前清蛋白、清蛋白、C-反应蛋白(CRP)水平,以及急性生理功能和慢性健康状况评分(APACHEⅡ);记录两组患者的并发症[多器官功能障碍(MODS)、肺炎、呼吸衰竭、胰周脓肿]发生率,住院时间及病死率等。结果A组血淀粉酶、前清蛋白、清蛋白水平均低于B组(P<0.05),CRP水平及APACHEⅡ评分均高于B组(P<0.05)。两组均无死亡病例,A、B组患者并发症发生率分别为86.00%(43/50)、17.14%(12/70),A组患者肺炎及胰周脓肿发生率明显高于B组(P<0.05);住院时间明显长于B组,两组患者比较差异有统计学意义(P<0.05)。结论SAP患者存在营养不良风险比较普遍,在临床工作中应重视营养风险筛查,对存在营养不良风险的SAP患者需及时进行营养干预。
Objective To explore the relationship between the nutritional risk screening and clinical outcomes in the patients with severe acute pancreatitis(SAP)in order to provide an evidence for clinical diagnosis,treatment and prognosis of SAP.Methods One hundred and twenty patients with SAP in this hospital from January 2015 to November 2018 were selected.The Nutritional Risk Screening 2002(NRS-2002)was used to conduct the nutritional risk screening within 24 h after admission.According to the NRS-2002 score,the patients were divided into the group A(NRS-2002 score≥3,n=50)and group B(NRS-2002 score<3,n=70).Both groups were given the routine treatment measures of SAP.The levels of serum amylase,prealbumin(PA),albumin(ALB),C-reactive protein(CRP)and acute physiological function and chronic health status score(APACHEⅡ)were compared between the two groups.The incidence rates of complications(MODS,pneumonia,respiratory failure,peripancreatic abscess),hospitalization time and mortality rate were recorded in the two groups.Results The levels of serum amylase,PA and ALB in the group A were lower than those in the group B.The levels of CRP and APACHEⅡin the group A were higher than those in the group B,and the differences between the two groups were statistically significant(P<0.05).The two groups had no death case.The incidence rates of complications in the two groups were 86.00%(43/50)and 17.14%(12/70)respectively.The complications incidence rates of pneumonia and peripancreatic abscess and the hospitalization time in the group A greater than those in the group B(P<0.05);the hospitalization time in the group Awas significantly longer than in the group B,and the difference was statistically significant(P<0.05).Conclusion The malnutrition risk existence is common in SAP patients,in the clinical work,the attention should be paid to the nutritional risk screening,and the nutrition intervention should be timely conducted to SAP patients with malnutrition risk.
作者
李莉
宁华英
刘晖
马剑
李娇
LI Li;NING Huaying;LIU Hui;MA Jian;LI Jiao(Department of General Surgery,Tianjing Municipal Haihe Hospital,Tianjing 300350,China;Department of Nutrition,Tianjing Municipal Haihe Hospital,Tianjing 300350,China)
出处
《重庆医学》
CAS
2020年第9期1413-1416,共4页
Chongqing medicine
基金
天津市卫生局科技基金项目(2011KZ38)。
关键词
重症急性胰腺炎
营养风险筛查2002
临床结局
早期
肠道营养
severe acute pancreatitis
nutritional risk screening 2002
clinical outcomes
early
enteral nutrition
