Early Enteral Nutrition Is Superior to Delayed Enteral Nutrition for the Prevention of Infected Necrosis and Mortality in Acute Pancreatitis

被引：103

作者：

Wereszczynska-Siemiatkowska, Urszula ^{[1
,2
]}

Swidnicka-Siergiejko, Agnieszka ^{[1
,2
]}

Siemiatkowski, Andrzej ^{[3
]}

Dabrowski, Andrzej ^{[1
,2
]}

机构：

[1] Med Univ Bialystok, Dept Gastroenterol, PL-15276 Bialystok, Poland

[2] Med Univ Bialystok, Dept Internal Med, PL-15276 Bialystok, Poland

[3] Med Univ Bialystok, Dept Anaesthesiol & Intens Therapy, PL-15276 Bialystok, Poland

来源：

PANCREAS | 2013年 / 42卷 / 04期

关键词：

pancreatitis; enteral nutrition; necrosis; mortality; ACUTE NECROTIZING PANCREATITIS; PARENTERAL-NUTRITION; PRACTICE GUIDELINES; SUPPORT; METAANALYSIS; SEVERITY; TRIAL; SCORE; COMPLICATIONS; DYSFUNCTION;

D O I：

10.1097/MPA.0b013e318271bb61

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

Objectives: The exact time of initiation of total enteral nutrition (TEN) in severe acute pancreatitis (SAP) and its influence on the disease outcome are not well known. Methods: An analysis of 197 cases with predicted SAP allocated to: group A (n = 97), early TEN (started within the first 48 hours after admission to hospital); and group B (n = 100), delayed TEN (started after 48 hours). Results: Infection of necrosis/fluid collections occurred in 4 patients in group A and 18 patients in group B (P < 0.05). Respiratory failure and transfer to intensive care unit occurred more frequently in group B than in group A (15 vs 5 and 15 vs 3 patients; P < 0.05). Multiple-organ failure was observed in 9 patients in group A and 16 patients in group B (P > 0.05). Seven patients in group A and 11 patients in group B underwent surgery (P > 0.05). All 9 reported deaths occurred in group B (P < 0.05). The time to start TEN was a predictor of infected necrosis/fluid collection (odds ratio, 4.09; P = 0.028). Conclusions: Delayed compared to early TEN is associated with higher mortality, increased frequency of infected necrosis/fluid collections, respiratory failure, and a need for intensive care unit hospitalization. Enteral nutrition in SAP should be started within 48 hours after admission to hospital.

引用

页码：640 / 646

页数：7

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