Application and preliminary evaluation of nutritional support in acute pancreatitis of pregnancy

Wenjun LUO; Chunhua LI; Hui LIN; Yuanyu ZHENG

doi:10.16016/j.1000-5404.201703180

您当前的位置：

首页 >

文章列表页 >

Application and preliminary evaluation of nutritional support in acute pancreatitis of pregnancy

Clinical Medicine | 更新时间：2026-01-09

- Application and preliminary evaluation of nutritional support in acute pancreatitis of pregnancy
- Journal of Third Military Medical University Vol. 39, Issue 13, Pages: 1400-1403(2017)
- 作者机构：
  
  400037 重庆，第三军医大学新桥医院消化内科
- 作者简介：
- 基金信息：
  
  the Clinical Research Project of Xinqiao Hospital of Third Military Medical University(2013XQHLYG-14)
- DOI：10.16016/j.1000-5404.201703180
  CLC： R459.3;R576;R714.255
- Received：29 March 2017，
  
  Revised：2017-04-26，
  
  Published：15 July 2017
- 稿件说明：
移动端阅览
Wenjun LUO, Chunhua LI, Hui LIN, et al. Application and preliminary evaluation of nutritional support in acute pancreatitis of pregnancy[J]. Journal of Third Military Medical University, 2017, 39(13): 1400-1403.
DOI：

Wenjun LUO, Chunhua LI, Hui LIN, et al. Application and preliminary evaluation of nutritional support in acute pancreatitis of pregnancy[J]. Journal of Third Military Medical University, 2017, 39(13): 1400-1403. DOI： 10.16016/j.1000-5404.201703180.

摘要

目的

评价营养支持在妊娠合并急性胰腺炎患者中的应用及其疗效。

方法

以我科2013年1月至2016年6月期间住院治疗的全部31例妊娠合并急性胰腺炎患者为研究对象，描述营养支持的应用，并比较肠外营养(parenteral nutrition，PN)与肠外营养联合肠内营养(enteral nutrition，EN)应用的临床效果。

结果

妊娠合并轻症急性胰腺炎患者8例(25.81%)均未进行营养支持，妊娠合并中重症急性胰腺炎患者中，分别有32.26%(10/31) 和41.94%(13/31) 的患者采用PN、PN和EN联合进行营养支持。PN和EN联合营养支持治疗组的感染发生率(18.18%)、腹胀缓解时间(3.85±1.07) d、体温恢复正常时间(6.31±2.29) d、住院时间以及住院费用均显著低于PN支持治疗组(

＜0.05)，但不同营养支持方式治疗组间的胎儿终止妊娠率、早产率和足月生产率差异无统计学意义(

＞0.05)。

结论

在妊娠合并急性胰腺炎病例中，营养支持应用广泛；肠外营养与肠内营养联合营养支持总体临床效果优于肠外营养。

Abstract

Objective

To investigate the application and evaluate the effects of different nutritional support therapies in the pregnant women with acute pancreatitis.

Methods

Thirty-one pregnant women with acute pancreatitis admitted in our department from January 2012 to June 2016 were recruited in this study. The differences between the nutritional status of patients who accepted parenteral nutrition (PN) alone or combined parenteral and enteral nutrition (PN+EN) were described and evaluated for clinical efficacy.

Results

There were 8 patients (8/31

25.81%) with mild acute pancreatitis treated with no any nutritional support therapy. Ten of the 31 patients (10/31

32.26%) with moderate pancreatitis were treated

with PN alone

and the left 13 (13/31

41.94%) were treated with PN+EN. The PN+EN group had an infection incidence of 18.18%

bradycardia duration of 3.85±1.07 d

and time of returning to normal temperature of 6.31±2.29 d. The length of hospital stay and the hospitalization costs were significantly lower in the PN+EN group than the PN group (

0.05). However

there were no significant differences in the terminating pregnancy rate

preterm birth rate and term birth rate between the 2 groups (

0.05).

Conclusion

In the cases of acute pancreatitis in pregnancy

nutritional support should be widely applied. PN+EN is superior to PN alone in clinical practice.

关键词

Keywords

references

XU Q, WANG S, ZHANG Z. A 23-year, single-center, retrospective analysis of 36 cases of acute pancreatitis in pregnancy[J]. Int J Gynaecol Obstet, 2015, 130(2): 123-126. DOI:10.1016/j.ijgo.2015.02.034.

GILBERT A, PATENAUDE V, ABENHAIM HA. Acute pancreatitis in pregnancy: a comparison of associated conditions, treatments and complications[J]. J Perinat Med, 2014, 42(5): 565-570. DOI:10.1515/jpm-2013-0322.

IGBINOSA O, PODDAR S, PITCHUMONI C. Pregnancy associated pancreatitis revisited[J]. Clin Res Hepatol Gastroenterol, 2013, 37(2): 177-181. DOI:10.1016/j.clinre.2012.07.011.

肖炳华, 黄耿文, 李宜雄, 等.妊娠期急性胰腺炎:单中心20年52例分析[J].中国普通外科杂志, 2014, 23(3):297-300. DOI: 10.7659/j.issn.1005-6947.2014.03.006.

XIAO B H, HUANG G W, LI Y X, et al .Acute pancreatitis during pregnancy:a 20-year single-center experience of 52 cases[J ] . Chin J Gen Sur, 2014, 23(3): 297-300. DOI: 10.7659/j.issn.1005-6947.2014. 03.006.

PAPADAKIS E P, SARIGIANNI M, MIKHAILIDIS D P, et al . Acute pancreatitis in pregnancy: an overview[J ] . Eur J Obstet Gynecol Reprod Biol, 2011, 159(2): 261-266. DOI:10. 1016/j.ejogrb.2011.07.037.

贺芳, 唐小林.妊娠合并急性胰腺炎的研究进展[J].中华产科急救电子杂志, 2016, 5(1):55-57. DOI:103877/cma.j.issn. 2098-3259.2016 01.014.

HE F, TANG X L. Research progress of pregnancy complicated with acute pancreatitis[J]. Chin J Obstet Emerg(Elec-Ed), 2016, 5(1):55-57. DOI: 103877/cma.j.issn.2098-3259.2016 01.014.

FORSMARK C E, VEGS S S, WILCOX C M. Acute Pancreatitis[J]. N Engl J Med, 2016, 375:1972-1981. DOI:10.1056/NEJMral505202.

王兴鹏, 李兆申, 袁耀宗, 等.中国急性胰腺炎诊治指南(2013, 上海)[J].中华胰腺病杂志, 2013, 13(2):73-78. DOI:10.3969/j.issn.1008-7125.2013.07.010.

WANG X P, LI Z S, YUAN Y Z, et al . Guidelines for diagnosis and treatment of acute pancreatitis in China (2013, Shanghai)[J ] . Chin J Pancreatol, 2013, 13(2):73-78. DOI:10.3969/j.issn. 1008-7125.2013.07.010.

MIRTALLO J M, FORBES A, MCCLAVE S A, et al . International consensus guidelines for nutrition therapy in pancreatitis[J ] . J Parenter Enteral Nutr, 2012, 36(3): 284-291. DOI:10.1177/0148607112440823.

YI F, GE L, ZHAO J, et al . Meta-analysis: total parenteral nutrition versus total enteral nutrition in predicted severe acute pancreatitis[J ] . Intern Med, 2012, 51(6): 523-530. DOI:10.2169/internalmedicine.51.6685.

LODEWIJKX P J, BESSELINK M G, WITTEMAN B J, et al . Nutrition in acute pancreatitis: a critical review[J ] . Expert Rev Gastroenterol Hepatol, 2016, 10(5): 571-580. DOI:10. 1586/17474124.2016.1141048.

MCCLAVE S A, CHANG W K, DHALIWAL R, et al . Nutrition support in acute pancreatitis: a systematic review of the literature[J ] . JPEN J Parenter En teral Nutr, 2006, 30(2): 143-156. DOI:10.1177/0148607106030002143.

HATA T, SAKATA N, OKADA T, et al . Dilated papilla with mucin extrusion is a potential predictor of acute pancreatitis associated with intraductal papillary mucinous neoplasms of pancreas[J ] . Pancreatology, 2013, 13(6): 615-620. DOI:10.1016/j.pan.2013.09.003.

杨绪兰, 罗莉, 余友敏, 等.TPN和EN对急性胰腺炎患者肠屏障和免疫功能的影响[J].西南国防医药, 2016, 26(6):584-586. DOI: 10.3969/j.issn.1004-0188.2016.06. 002.

YANG X L, LUO L, YU Y M, et al . Effects of TPN and EN on intestinal barrier and immune function in patients with acute pancreatitis[J ] . Med J Nati Defending Forces Southwest China, 2016, 26(6):584-586. DOI:10.3969/j.issn.1004-0188.2016.06.002.

夏龙, 胡文秀, 欧阳晓晖.肠外营养与肠内营养结合治疗重症急性胰腺炎的体会(附200例报道).中国普外基础与临床杂志, 2016, 23(4):439-444. DOI:10.7507/1007-9424. 20160116.

XIA L, HU W X, OUYANG X H. Parenteral nutrition and enteral nutrition combined with the experience of treatment of severe acute pancreatitis with 200 cases report[J]. Chin J Bases Clin General Surg, 2016, 23(4):439-444. DOI:10.7507/1007-9424.20160116.

JIN J, YU Y H, ZHONG M, et al . Analyzing and identifying risk factors for acute pancreat itis with different etiologies in pregnancy[J ] . J Matern Fetal Neonatal Med, 2015, 28(3): 267-271. DOI:10.3109/14767058.2014. 913132.

TAO Y, TANG C, FENG W, et al .Early nasogastric feeding versus parenteral nutrition in severe acute pancreatitis: A retrospective study[J ] . Pak J Med Sci, 2016, 32(6):1517-1521. DOI: 10.12669/pjms.326.11278.

ZHU Y, YIN H, ZHANG R, et al .Nasogastric nutrition versus nasojejunal nutrition in patients with severe acute pancreatitis: a meta-analysis of randomized controlled trials[J ] . Gastroenterol Res Pract, 2016, 2016: 6430632. DOI: 10.1155/2016/6430632.

DAI Y J, SUN L L, LI M Y, et al . Comparison of formulas based on lipid emulsions of olive oil, soybean oil, or several oils for parenteral nutrition: a systematic review and meta-analysis[J ] . Adv Nutr, 2016, 7(2): 279-286. DOI: 10.3945/an.114.007427.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Continuous plasma filtration adsorption for treatment of acute pancreatitis in pregnancy: analysis of 18 cases

Perioperative anesthesia management for pregnant patients with pulmonary arterial hypertension

Thrombotic thrombocytopenicpurpura during pregnancy: report of 2 cases and literature review

Predictive value of soluble urokinase-type plasminogen activator receptor in patients with severe acute pancreatitis

Tetralogy probiotics combined with galactooligosaccharides in prevention of diarrhea in patients with severe craniocerebral injury

Related Author

邓雨峰

陈翔

何月

张海燕

黄金园

熊亚

文静

何青盈

Related Institution

Department of Anesthesia, Second Affiliated Hospital, Army Medical University (Third Military Medical University)

Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University

Ultrasound Ablation Center, the First Affiliated Hospital of Chongqing Medical University

Department of Gastroenterology, Changhai Hospital, Navy Medical University (Second Military Medical University)

Department of Cancer Biology, Mayo Clinic

⁰