重症急性胰腺炎合并乳糜瘘患者肠内营养期间的安全管理

摘要

Objective To explore the safety management methods for severe acute pancreatitis patients with chylous fistula during the course of enteral nutrition. Methods This paper summarized the safety management methods of 5 cases of severe acute pancreatitis patients with chylous fistula retrospectively,including implementing appropriate enteral nutrition at appropriate time, taking effective nursing measures ,carefully monitoring the amount of peritoneal drainage,triglyceride concentration, and the results of celiac tests. Results Through the supporting therapy of enteral nutrition, the triglyceride concentration of aacites declined significantly,and the amount of drainage also gradually decreased and disappeared at last. Their chylous fistula was cured by conservative treatment.Conclusion Enteral nutrition is the important means of nutritional support for severe acute pancreatitis patients with chylous fistula. Good management of enteral nutrition can effectively prevent from aggravation and recurrence of chylous fistula.%目的 探讨重症急性胰腺炎合并乳糜瘘患者在实施肠内营养期间安全管理的方法.方法 分析5例普通外科ICU内重症急性胰腺炎合 并乳糜瘘患者实施肠内营养过程的安全管理方法,包括:在合适的时间进行合适的肠内营养,采取合理有效的护理措施、严密监测腹腔引流液量及其甘油三酯浓度和乳糜试验的变化.结果 5例患者应用肠内营养支持治疗后,腹水中甘油三酯的浓度显著下降,引流量逐渐减少以至消失,最终5例患者均通过保守治疗后乳糜瘘自行愈合.结论 肠内营养是重症急性胰腺炎合并乳糜瘘患者营养支持的重要手段,良好的肠内营养管理可有效预防乳糜瘘加重和复发.