Comparison of the clinical efficacy and prognosis between early enteral nutrition and total parenteral nutrition in the treatment of severe pancreatitis

ObjectiveTo compare the clinical efficacy and prognosis between early enteral nutrition and total parenteral nutrition in the treatment of severe acute pancreatitis.

MethodsEighty patients with severe pancreatitis were randomly divided into the control group and observation group(40 cases each group).The control group was treated with total parenteral nutrition, and the observation group was treated with early enteral nutrition.The recovery time of hemodiastase and urine amylase levels, hospital stay, levels of total serum protein, albumin and urea nitrogen, percentage of blood lymphocyte, inflammatory factor level, cellular immune function and APACHEⅡ score between two groups were compared.

ResultsThe recovery time of hemodiastase, recovery time of urine amylase and hospital stay in observation group after treatment were significantly shorter than those in control group(P < 0.01).The levels of total serum protein, albumin, urea nitrogen and percentage of blood lymphocyte in observation group after treatment were significantly higher than those in control group(P < 0.01).After treatment, the levels of TNF-α, IL-1β, IL-6, IL-8 and endotoxin in two groups significantly decreased compared with before treatment(P < 0.05 to P < 0.01), and the levels of TNF-α, IL-1β, IL-6, IL-8 and endotoxin in observation group were significantly lower than those in control group(P < 0.01).Compared with before treatment, the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ significantly increased(P < 0.01), and the level of CD8⁺ significantly decreased in two groups after treatment(P < 0.05).After treatment, the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in observation group were significantly higher than those in control group(P < 0.01), and the level of CD8⁺ in observation group was significantly lower than that in control group(P < 0.01).The APACHEⅡ score in observation group after 24h, 48h and 72h of treatment was significantly lower than that before treatment(P < 0.01), the APACHEⅡ score in observation group after 48 h and 72h of treatment was significantly lower than that after 24h of treatment(P < 0.05 and P < 0.01), and the APACHEⅡ score in observation group at each time-point was significantly lower than that in control group(P < 0.05 to P < 0.01).

ConclusionsEarly enteral nutrition in the treatment of severe pancreatitis can effectively reduce the inflammatory factor level, enhance cellular immune function, and improve prognosis of patients.