Early parenteral nutrition in severe acute pancrea -

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Early parenteral nutrition in severe acute pancreatitis treatment of

Down, sugar use disorder, the body break down muscle protein for energy dependent, resulting in branched chain amino acid / aromatic amino acid ratio decreased, a large number of urinary nitrogen loss, the amount of daily nitrogen loss can be up to 40g; together like exudative peritoneal , increased protein loss, plasma total protein and albumin values falling sharply, this is known as pancreatitis and burns or the consequences of intra-abdominal burns to the patient's immune dysfunction. Patients for the maintenance of the structure and function of vital organs, improving the body condition, so that it can make it through this dangerous period, effective nutritional support is very necessary. Severe acute pancreatitis is a digestive disease itself, and thus, reduce pancreatic secretion to prevent the progress of inflammation, to prevent the disease Research has shown that: oral feeding of pancreatic secretion stimulated the strongest. Enteral nutrition can make inside and outside the pancreas and the secretion of gastric emptying significantly stimulate the pancreas is not conducive to consumption; In addition, the intestinal tract is the role of the central organ stress, pancreatitis, due to stress reactions, and to ensure the heart, brain and other vital organs of the blood supply, blood supply to reduce the intestinal wall, intestinal perfusion decreased, resulting in mucosal ischemia, seal the top hair cell necrosis, mucosal permeability by Zhejiang Medicine Volume 24, 2002, a strong decline in the immune barrier function [41. Enteral nutrition at this stage, not only nutrients can not be digested and absorbed, but will increase the intestinal damage, increased bacterial and endotoxin translocation. Therefore, in order to provide sufficient calories and protein A, to supplement the body's energy consumption, maintenance of function of important organs, patients with severe acute pancreatitis early nutrient supply is better to parenteral nutrition in patients with severe acute pancreatitis in parenteral nutrition support can also inhibit the pancreatic exocrine activities to pancreatic secretion. Reduce the 5o% ~ 70%, the mechanism is in a parenteral nutrition to rest the entire digestive tract, pancreas intestines to eliminate reflections and reduce the release of intestinal hormones to prevent intestinal absorption of nutrients by the direct effect of pancreatic clinical studies have shown total nutrient mixture of glucose, fat emulsion and amino acids, either pure or mixed infusion infusion sets, not produce the stimulation of pancreatic exocrine Sandostatin is a synthetic octapeptide derivative of somatostatin on multiple endocrine digestive tract has a strong inhibitory effect. Sandostatin combined with TPN for the treatment of severe acute pancreatitis, inhibition of pancreatic secretion can play a full role, both as to provide sufficient heat,[link widoczny dla zalogowanych], more conducive to patient recovery. This information, TPN plus Sandostatin urinary amylase returned to normal time was significantly shorter than with Sandostatin group, while the recovery time of gastrointestinal function was significantly shorter than the Sandostatin group (all P <0.01) This shows that when patients with severe acute pancreatitis and gastrointestinal dysfunction in critically ill condition, the TPN can provide effective nutritional support to meet the nutritional state of high metabolic demand, maintaining vital organs function, improved body condition, but also of disease the pathological process of the block has a positive effect (eg, reduced pancreatic secretion), thus helping patients to return and shorten the course. In addition, we recovery of gastrointestinal function in patients, after flatus 2d, to further stabilize the disease, began gradually to a small amount of enteral nutrition in order to protect the intestinal mucosa barrier function and prevent translocation of intestinal flora, reducing intestinal the incidence of infectious complications, avoid long-term adverse effects of parenteral nutrition. 3

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