Role of gradually combined treatment of parenteral nutrition with enteral nutrition for severe acute pancreatitis

Objective To assess the therapeutic efficacy of gradually combined treatment of parenteral nutrition with enteral nutrition for severe acute pancreatitis(SAP),and to search for a suitable way of nutritional support treatment.Methods The clinical data of 130 cases of SAP were analysed retrospectively.Of them,59 cases were treated by general methods of nutritional support(A group),and the other 71 cases treated by gradually combined treatment of parenteral nutrition with enteral nutrition(B group).The score of acute physiology and chronic health evaluationⅡ(APACHEⅡ),complications,mortality and curative rate,mean hospital stay,and the cost of hospitalization were observed;and liver function was detected.In 31 cases,including 13 cases in group A and 18 cases in group B,serum IL-6 level was tested.Results(1) With passage of time,both APACHEⅡ and IL-6 levels in group B decreased.The differences were significant between the results after 7 d and 14 d compared with group A whose degression tendency was slow(P0.05).(2) The rate of liver function insufficiency:there was no significant difference between the two groups before therapy(P0.05),but after 14 d,the rate of group B decreased more obviously than that of group A(P0.05).(3) The serum albumin levels of group A and B were(29.7±4.2)g/L and(30.01±5.7)g/L respectively after 14 d treatment.There was no significant difference between the two groups(P0.05).(4) Complications rate and mortality,the mean hospital stay and the cost of hospitalization of group B were [39.4%,12.7%,(32±9) d and(30 869.4±12 794.6) yuan] respectively,which were lower than those of group A[66.1%,30.5%,(53±11) d and(45 534.2±13 030.5) yuan](P0.05).However,the curative rate of group B(81.7%) was obviously higher than that of group A(59.3%)(P0.05).Conclusion The gradually combined nutrition support treatment can improve the prognosis,nutrition status and the therapeutic efficacy of SAP.Such combined nutrition support treatment playes an important role in reducing complications,mortality,the mean hospital stay and the cost of hospitalization in the patients with SAP.