普通外科危重患者围手术期的营养支持

目的：研究普通外科危重患者围手术期营养支持的临床疗效。方法：对1995年以来147例普通外科危重患者围手术期营养支持应用情况进行了分析，腹部手术138例（93.9%)，颈部手术9例（6.1%)，采用以全胃肠外营养（TPN）为主的阶段性营养支持方法补充营养。深静脉置管方法：经颈内静脉置管132例（89.8%)、腋静脉11例（7.5%)、股静脉4例（2.7%)，使用单腔导管127例（86.4%)，双腔20例（13.6%)，41例（27.9%)，放置肠内营养（EN）管。106例（72.1%)为TPN→PN 口服饮食→口服饮食，41例（27.9%)为TPN→PN EN→EN→EN 口服饮食→口服饮食。结果：本组营养支持期间无置管和代谢并发症。142例（96.6%)康复，5例（3.4%)死于原发病。结论：普通外科危重患者围手术期营养支持是重要辅助治疗方法，可保证手术安全，促进术后康复。

Nutrition support of severe illness patients of general surgery during perioperation period

OBJECTIVE: To study the clinical effect of the nutrition support of severe illness patients of general surgery during perioperation period. METHODS: To analyse application of the nutrition support applied to 147 cases with severe illness of general surgery in perioperation period since 1995. In 147 cases, there were abdominal operations(n=138, 93.9%) and cervical operations(n=9, 6.1%) and emergency operations (n=63, 42.8%). Total parenteral nutrition (TPN) was used by venous cannal ways including internal juglar vein (n=132, 89.8%), axillary vein (n=11, 7.5%), femoral vein (n=4, 2.7%), used unicameral catheter (n=127, 86.4%), double catheter (n=20, 13.6%), 41 cases were used enteral nutrition. Two different nutritional support treatments were employed, one was TPN-->parenteral nutrition(PN)+oral diet-->oral diet (n=106, 72.1%) and another was TPN-->PN+enteral nutrition(EN)-->EN-->EN+oral diet-->oral diet (n=41, 27.9%). RESULTS: There were not complications of catheterization and metabolism in the nutrition support, 142 cases (96.6%) had been cured and 5 cases (3.4%) died of primary diseases after operation. CONCLUSION: The nutrition support of patients with severe illness of general surgery in perioperation period is an important adjuvant treatment that can assure operative safety and promote recovery on postoperation.