The Effectiveness Of Early Enteral Nutrition In The Patients With Severe Acute Pancreatitis (Clinical Analysis Of 48 Cases With SAP)

Aim:This study was undertaken to evaluate the effect of enteral nutrition versus parenteral nutrition on serum markers of inflammation and outcome in patients with severe acute pancreatitis.Methods:Forty-eight patients with severe acute pancreatitis were divided randomly into enteral nutrition group(n=24, Group EN)and parenteral nutrition group(n=24,Group PN)with in 24 to 48 hours of admission. We measured the recovery time from symptoms, physical signs and laboratory parameters [white blood cell count(WBC), C-reactive protein(CRP)and serum amylase]; Serum albumin levels, prealbumin, duration of hospital Stay, APACHEII score, CT score, incidences of multiple organ dysfunction syndrome(MODS)and infection of pancreas and peripancreas were observed.Results:Recovery time from symptoms, physical signs and laboratory parameters in group EN was significantly shorter than that in group PN (P<0.05). Serum albumin rose from a prenutritional value of 30.2±5.1 g/L to 38.4±4.5 g/L on day 14 of nutritional support in the enteral nutrition group (P=0.003); in the total parenteral nutrition group, the level rose from 31.0±5.9 g/L to 32.1±3.0 g/L (P=0.638). A significant rise in prealbumin value was observed from day 0 to day 14 in enteral nutrition group (195.6±56.4 to 251.6±46.4 mg/L; P＜0.001) whereas, in the total parenteral nutrition group, a less significant difference (192.8±31.7 to 216.4±50.6mg/L; P=0.044) was observed. Length of stay in group EN were shorter than those in group PN(P<0.05). APACHEⅡscore and CT score decreased significantly on 14 day after enteral nutrition. Incidences of MODS and infection of pancreas and peripancreas decreased significantly in group EN(P<0.05).Conclusion:EN was safe, feasible and easy to put into practice. Reasonable applications may significantly improve the nutritional status of the SAP patients.