Effects Of Early Enteral Nutrition On Gastrointestinal Function And Prognosis Of Severe Acute Pancreatitis

ObjectiveTo investigate the effect of early enteral nutrition(EEN)on gastrointestinal function recovery and prognosis in patients with severe acute pancreatitis(SAP).Methods38 SAP patients admitted to the emergency department of the first affiliated hospital of zhengzhou university from January 2018 to December 2018 were collected and divided into the EEN group(20 cases)and delayed enteral nutrition group(DEN 18 cases)according to whether enteral nutrition(EN)could be started within 48 hours after admission.On the basis of routine treatment,EN was started within 48 hours after admission in patients in the EEN group and 48 hours after admission in patients in the DEN group.Plasma amylase,c-reactive protein(CRP)level and white blood cell(WBC)count were detected in the two groups patients within 24 hours,3rd day,7th day and 14 th day after admission.Acute physiology and chronic health status II score(APACHE-II score),acute gastrointestinal injury(AGI)score,serum diamine oxidase(DAO),D-lactate(d-lac)and Lipopolysaccharides(LPS)were observed.The remission time of abdominal diarrhea and distension,the remission time of nausea and vomiting,the recovery time of intestinal rumbling and the time of anal exhaust were observed.The incidence rate,fatality rate,length of stay and hospitalization expenses of in patients peripancreatic infection rate,pulmonary infection rate,multiple organ disfunction(MODS)were calculated.ResultsThere were no statistically significant differences in gender composition ratio,age composition ratio and body mass index between the two groups(P >0.05).The levels of CRP,WBC quantity,APACHE-II score and AGI score in the EEN group patients were significantly lower than those in the DEN group patients on the 7th and 14 th days after admission(P <0.05).On the 7th day and the 14 th day of the disease,the levels of CRP level,WBC count,APACHE-II score and AGI score in the EEN group patients were significantly lower than those in the DEN group patients(P <0.05).The levels of DAO,D-lac and LPS in the EEN group patients were significantly lower than those in the DEN group patients on the 7th day and the 14 th day after admission(P <0.05).The EEN group had shorter relief time of abdominal diarrhea and distension,nausea and vomiting,bowel sounds and anal exhaust than the DEN group(P <0.05).Compared with DEN group,EEN group showed no significant difference in peripancreatic infection rate,pulmonary infection rate,The incidence of MODS and mortality,but the overall trend was downward(P >0.05).The hospitalization time of EEN group was shorter than that of DEN group(P <0.05);Hospitalization costs were lower in the EEN group than in the DEN group(P <0.05).ConclusionIn SAP patients,EEN treatment can promote the recovery of intestinal mucosal injury,can promote the recovery of gastrointestinal dysfunction,can reduce the occurrence of complications and improve the prognosis.