Diao Wei,He Feng.Therapeutic effect of early oral feeding on pediatric mild acute pancreatitis[J].Journal of Clinical Pediatric Surgery,,20():631-634.[doi:10.12260/lcxewkzz.2021.07.007]
Therapeutic effect of early oral feeding on pediatric mild acute pancreatitis
- CLC:
- R725.761;R459.3
- Abstract:
- Objective To explore the therapeutic effect of early oral feeding on pediatric mild acute pancreatitis (PMAP).Methods A total of 36 PMAP children were divided into two groups of control (n=16) and study (n=20).The control group received a traditional treatment regimen,i.e.routine fasting for 1 to 7 days and then timing of oral feeding was determined by the relief of abdominal pain symptoms,hunger,disappearance of adverse signs,normalization of blood pancreatic amylase and lipase and recovery of gastrointestinal function.The study group began to resume a light,liquid and fat-free diet.The serum levels of amylase,lipase and C-reactive protein (CRP) of two groups at treatment day 1/4/7 were observed and analyzed statistically.Severity of pain (from Day 1 to 3),length of hospital stay and incidence of complications were recorded and analyzed statistically.Results After treatment,serum levels of amylase,lipase and CRP of two groups decreased markedly.And no statistical difference existed in three indices at Day1/4/7.Two groups had varying degrees of abdominal pain at Day 3 after treatment.However,the overall trend improved.No correlation existed between early oral feeding and abdominal pain.The length of stay was (11.63±2.00) versus (9.90±1.86) days in control and study groups respectively and the difference was statistically significant (P<0.05).No significant inter-group difference existed in the incidence of nausea,vomiting,abdominal distension,diarrhea or other complications.Conclusion Early oral feeding of PMAP may achieve a shorter hospital stay than traditional fasting,without an aggravation of inflammation,abdominal pain and complications.
References:
1 Párniczky A,Abu-El-Haija M,Husain S,et al.EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis[J].Pancreatology,2018,18(2):146-160.DOI:10.1016/j.pan.2018.01.001.
2 Eckerwall GE,Tingstedt BB,Bergenzaun PE,et al.Immediate oral feeding in patients with mild acute pancreatitis is safe and may accelerate recovery-a randomized clinical study[J].Clin Nutr,2007,26(6):758-763.DOI:10.1016/j.clnu.2007.04.007.
3 Crockett S,Falck-Ytter Y,Wani S,et al.Acute Pancreatitis Guideline[J].Gastroenterology,2018,154(4):1102.DOI:10.1053/j.gastro.2018.02.029.
4 Berthold Koletzko,王卫平.临床儿科营养[M].北京:人民卫生出版社,2009:239-244. Berthold K,Wang WP.Clinical Pediatric Nutrition[M].Beijing:People’s Medical Publishing House,2009:239-244.
5 Abu-El-Haija M,Wilhelm R,Heinzman C,et al.Early enteral nutrition in children with acute pancreatitis[J].J Pediatr Gastroenterol Nutr,2016,62(3):453-456.DOI:10.1097/MPG.0000000000001013.
6 Pandey SK,Ahuja V,Joshi YK,et al.A randomized trial of oral refeeding compared with jejunal tube refeeding in acute pancreatitis[J].Indian J Gastroenterol,2004,23(2):53-55.
7 高晓莉,韩芳.急性胰腺炎的肠内营养支持进展[J].肝胆外科杂志,2012,20(5):394-396.DOI:10.3969/j.issn.1006-4761.2012.05.028. Gao XL,Han F.Advances of enteral nutrition support in acute pancreatitis[J].Journal of Hepatobiliary Surgery,2012,20(5):394-396.DOI:10.3969/j.issn.1006-4761.2012.05.028.
8 Petrov MS,Zagainov VE.Influence of enteral versus parenteral nutrition on blood glucose control in acute pancreatitis:a systematic review[J].Clin Nutr,2007,26(5):514-523.DOI:10.1016/j.clnu.2007.04.009.
9 Mcclave SA,Taylor BE,Martindale RG,et al.Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN)[J].Critical Care Medicine,2016,44(2):390-438.DOI:10.1097/CCM.0000000000001525.
10 Vieira JP,Araftjo GF,Azevedo JR,et al.Parenteral nutrition versus enteral nutrition in severe acute pancreatitis[J].Acta Cir Bras,2010,25(5):449-454.DOI:10.1590/s0102-86502010000500012.
11 李菁菁,王莹.儿童急性胰腺炎的肠内营养治疗进展[J].中国小儿急救医学,2017,24(1):5-8.DOI:10.3760/cma.j.issn.1673-4912.2017.01.002. Li JJ,Wang Y.Advances on enteral nutrition of children with acute pancreatitis[J].Chinese Pediatric Emergency Medicine,2017,24(1):5-8.DOI:10.3760/cma.j.issn.1673-4912.2017.01.002.
12 Abu-El-Haija M,Uc A,Werlin SL,et al.Nutritional considerations in pediatric pancreatitis:a position paper from the NASPGHAN Pancreas Committee and ESPGHAN Cystic Fibrosis/Pancreas Working Group[J].J Pediatr Gastroenterol Nutr,2018,67(1):131-143.DOI:10.1097/MPG.0000000000002023.
13 Uc A,Husain SZ.Pancreatitis in children[J].Gastroenterology,2019,156(7):1969-1978.DOI:10.1053/j.gastro.2018.12.043.
14 Ledder O,Duvoisin G,Lekar M,et al.Early feeding in acute pancreatitis in children:a randomized controlled trial[J].Pediatrics,2020,146(3):e20201149.DOI:10.1542/peds.2020-1149.
Memo
收稿日期:2019-11-28。
基金项目:南充市市校科技战略合作项目（编号：18SXHZ0332）
通讯作者:何凤,Email:348087636@qq.com