Clinical research of early oral feeding in mild acute pancreatitis patients / 肠外与肠内营养

ABSTRACT

Objective: In acute pancreatitis, traditional treatment insists fasting on purpose to avoid activation of proteolytic enzymes and pancreatic enzyme secretion. The aim of our study was to evaluate the efficacy and feasibility of early oral feeding as compared to traditional fasting in patients with mild acute pancreatitis.Methods: Seventy-two patients were randomized to the two treatment groups, fasting or early oral feeding. The inclusion criteria were pancreas amylase≥3times above normal, onset of abdominal pain within 48h, acute physiological and chronic health evaluation-II score<8 and C-reactive protein(CRP)<150 mg/L. Measures were amylase, systemic inflammatory response, length of hospital stay. Results: The groups were comparable with respect to age, sex, etiology, APACHE II, time from onset of pain and amylase at admission. No significant differences were seen between the groups concerning levels of amylase, CRP, leukocytes, abdominal pain or number of gastrointestinal symptoms. The length of hospital stay time was significantly shorter in the oral feeding group (13 vs. 17 days; P<0.05).Conclusion: Early oral feeding would not exacerbate disease process. The differences between treatment groups for amylase or systemic inflammatory response were not obvious. In mild acute pancreatitis, early oral feeding was feasible and safe and may accelerate recovery.