全肠外营养在腹部外科围手术期的应用体会

目的自1998年12月以来对53例腹部大、中手术的病人，在围手术期辅以全肠外营养支持治疗(TPN)的作用。

Experience of total parenteral nutrition during perioperative period in abdominal surgery

53 cases who underwent major and moderate abdominal surgery were administered total paraenteral nutrition(TPN) by double energy resources and "all in one" irffusion way since December 1998. Non-protein energy was 105～150KJ/kg·d. Nitrogen was 0.16 ～0.35g/kg·d, Fat was 30%～40% of total energy. Serum protein of the cases were approximately or exceeded preoperative level. Body weight remained stable or increased (0.5～3kg). Positive nitrogen equilibrium was achieved 5～7d postoperatively. TPN improved the patients nutritional status, facilitated postoperative recovery and reduced the occurence of complications. We have the experience: (1) Appropriate nutrition support helps the critical patients of abdominal surgery tide over the long critical course and enhance curative rate. (2) It is necessary for the patients of obvious malnutrition and poor tolerance for operation to receive nutritional support for 5～7d. Postoperative TPN support should not be less than 1 week. (3)Infusion of nutritional ingredients should follow the principle of "metabolic support". (4)TPN can improve not only nutritional condition and immunity,but anticaneerous function of patients with gastrointestinal tract tumor combined with chemotherapy. (5)TPN support can reduce intestinal fluid leakage, facilitae fistua healing and prevent infection for patients with intestinal fistula. (6)TPN support can supply appropriately body needed nutrition and reduce exocrine secretion of pancreas for patients with severe pancreatitis.