ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 33 of 61
JMBS 2019, 4(5): 215–221
Clinical Medicine

Comparison of the Effectiveness of Enteral and Parenteral Nutrition in Patients with Acute Pancreatitis

Khanko Ye. 1, Volchenko I. 2

One of the main causes of death in patients with acute pancreatitis is the development of the immuno-inflammatory response to infected pancreatic necrosis. A number of studies have shown a decrease in the severity and incidence of septic complications in patients on enteral nutrition, after severe mechanical and thermal injuries, after extensive surgical interventions. It also allows maintaining the intestinal barrier function, which prevents the translation of microflora. Based on the foregoing, it can be assumed that enteral nutrition will have a positive effect on the course of acute pancreatitis. The purpose of this study was to determine the feasibility of enteral nutrition in patients with acute pancreatitis, the role of nutrition in the outcome of treatment and development of complications associated with this disease. Material and methods. This study analyzed the treatment of 35 patients with acute pancreatitis who received enteral or parenteral nutritional support. Patients were divided into two groups. The enteral nutrition group included 18 patients, and the group with parenteral nutritional support had 17 patients. The groups were comparable by sex and age to improve accuracy. The Mann U-test was used during statistical processing for nonparametric data and Yates correction – for parametric data. Results and discussion. The study was divided into three main stages. The first stage: from the moment of reception to 48 hours. During this period, the etiology of the disease was established, Glasgow and APACHE II scores were evaluated, C-reactive protein levels were measured, and severe patients were also evaluated on a Balthazar Severily Index CT scale. The second stage: a seven-day treatment period with nutritional support, parenteral or enteral, according to the randomization for each group. At the end of this period, the patients were again evaluated by the same method as in the first stage. The third stage: the period of time after the 7th day stage and until discharge. Both types of food were selected so that they could satisfy the daily requirements for nitrogen and calories. Electrolyte balance was achieved by intravenous infusion. There was a positive dynamics in the changes on the Glasgow and APACHE II scales, the dynamics of C-reactive protein in patients receiving enteral nutrition compared with patients on parenteral nutrition. There was also a decrease in the duration of hospitalization, the incidence of intra-abdominal sepsis, insufficiency of organs and systems, and, as a consequence, mortality of patients. Conclusion. Thus, enteral nutrition, compared with parenteral nutrition, allowed achieving better treatment results, reducing mortality, the incidence of systemic inflammatory response syndrome and peritonitis in patients with acute pancreatitis. Early enteral nutrition has proven to be an important part in the comprehensive treatment of patients with acute pancreatitis.

Keywords: acute pancreatitis, enteral nutrition, parenteral nutrition, nutritional support

Full text: PDF (Rus) 218K

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