肠内营养对重型破伤风患者营养支持的探讨

Objective To study the effect of enteral nutrition on patients with severe tetanus. Methods The patients totaled 60 cases were divided into two groups with 30 cases in each. The patients in EN group were treated with enteral nutrition on basis of routine treatment, control group was treated with total parenteral nutrition (TPN). The indicators values of BMI, TSF, MAMC, TP, PAm, m, ALB and Hb were tested on the day before nutrition supports and after nutrition supports 10 days later in two groups. Adverse reaction and the treatment effect were observed simultaneously. Results With nutritional supports 10 days later, two groups had no obvious decline in BMI, TSF and MAMC. TP, PA, ALB and Hb of EN group were higher than those of control group (P＜0.05) . Complication rate of EN group was lower than that of control group, there was significant differences (P＜0.05) . Conclusions Early EN may improve protein metabo lism in patients with severe tetanus and nutritional status.     

肠内营养对重型破伤风患者营养支持的探讨

Objective To study the effect of enteral nutrition on patients with severe tetanus. Methods The patients totaled 60 cases were divided into two groups with 30 cases in each. The patients in EN group were treated with enteral nutrition on basis of routine treatment, control group was treated with total parenteral nutrition (TPN). The indicators values of BMI, TSF, MAMC, TP, PAm, m, ALB and Hb were tested on the day before nutrition supports and after nutrition supports 10 days later in two groups. Adverse reaction and the treatment effect were observed simultaneously. Results With nutritional supports 10 days later, two groups had no obvious decline in BMI, TSF and MAMC. TP, PA, ALB and Hb of EN group were higher than those of control group (P＜0.05) . Complication rate of EN group was lower than that of control group, there was significant differences (P＜0.05) . Conclusions Early EN may improve protein metabo lism in patients with severe tetanus and nutritional status.     

Effect of early enteral and parenteral nutrition on visceral ischemic lesion of rat burn model

AIM:To compare the effects of early enteral nutrition and early parenteral nutrition on ameliorating visceral ischemia and relieving free radical damage.METHODS:66 Wistar rats were divided into 3 groups:control group (C),parenteral nutrition group(PN) and enteral nutrition group(EN),PN and EN groups made up of 30% TBSAⅢ degree bum model,We delivered nutrient solution with same calorie and calorie-nitrogen ratio via vein or enteral tract respectively.Blood flow of liver,kidney and change of SOD of heart,liver and kidney at 6,12,24,48,72h after burn were tested.RESULTS:Tissue blood flow and SOD of EN group were higher than those of PN group in many phase(P&;lt;0.05-0.01).CONCLUSION:Early enternal nutrition can relieve the increase of visceral vascular permeability and damage of oxygen free radical.     

肠内免疫营养对多发伤患者免疫功能的影响

Objective To study the effects of enteral immunonutrition on immune function in patients with multiple trauma. Method A total of 32 patients with multiple trauma admitted to general ICU in ChangZheng hospital, Shanghai from March 2007 to May 2008 were randomly (random number) divided into two groups,enteral immunonutrition group (EIN group, n = 16)and the general formula enteral nutrition group (EN group, n = 16).Two groups of patients on the third day after injury began to accept the EIN and the general formula EN which respectively support at least 14 days. The patients peripheral blood lymphocyte count (TLC), immunoglobulin (IgG,IgM, IgA) ,and T-lymphocyte subsets (CD3, CD4, CD8, CD4/CD8) were detected on the day of the group formation, the seventh and the fortteenth day of the nutritional support. Results TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher in EIN Group on the 7th and 14th day than that on the first day ( P ＜0.05), and extended with the EIN and sustained increase. All immunization indicators of EN group on the 7th day were no significant changes compared with the day of the group formation, and on the 14 th day TLC, IgG, IgM,IgA, CD4 and CD4/CD8 ratio were significantly higher than that on the day of the group formation ( P ＜ 0.05),but were significantly lower than that in the EIN group on the 14th day ( P ＜ 0.05). Conclusions Compared with the general formula EN, EIN is more helpful to restore and increase the humoral and cellular immune function in early post-multitraumatic phase.     

肠内营养治疗食管癌和贲门癌术后功能性胃排空障碍

目的 探讨肠内营养在功能性胃排空障碍治疗中的作用.方法 15例食管癌、贲门癌手术后功能性胃排空障碍患者,10例应用肠内营养,5例应用肠外营养,比较2组术后住院时间、胃肠减压 量、胃排空障碍恢复时间,评估肠内营养的疗效.结果 肠外营养组住院时间为(20.3±6.6)d,肠内营养组为(14.4±4.6)d;胃排空障碍恢复时间分别为(19±9)、(12±4)d.结论 肠内营养能促进胃肠道功能恢复,是治疗食管癌、贲门癌手术后功能性胃排空障碍的有效手段.

Abstract：

Objective To explore the role of enteral nutrition in the treatment of functional delayed gastric emptying. Methods Among 15 patients with functional delayed gastric emptying after resection of esophageal or gastric cardiac carcinoma, 10 patients were treated with enteral nutrition( EN group),5 patients were treated with parenteral nutrition (PN group). Postoperative hospital stay, gastrointestinal decompression amount, recovering time of postoperative gastric emptying were observed to assess the efficacy of enteral nutrition. Results The average postoperative hospital stay was ( 14. 4 ± 4. 6) days in the EN group, whereas (20. 3 ±6. 6) days in the PN group. The average recovering time of postoperative gastric emptying was (19 ±9)days in the PN group and( 12 ± 4)days in the EN group. Conclusion The method of EN can enhance gastric emptying and is effective for functional delayed gastric emptying after resection of esophageal or gastric cardiac carcinoma     

The effect of early enteral nutritive support on patients after esophageal and gastric operation

AIM：To investigate the availability and safety of early enteral nutritive support after esophageal and gastric operation.METHODS:The postoperative patients of esophageal and gastric operation were randomly divided into enteral nutrition(EN) group(n=20) and parenteral nutrition(PN) group(n=20) and were given nutritive support of same ammoni and same quantity of heat after postoperative 24 hours,continuously for 7 days.RESULTS:The patients of both groups recovered and were discharged after treatment.The assessing index of nutrition of EN group was better than PN group (see table of clinical index).And the hospitalization fees of EN group were lower than PN group.The time of hospitalization of EN group was also shorter than PN group.CONCLUSION:Early enteral nutritive support after esophageal and gestric operation was safety and the rehabilitation effect was obvious and had extensive clinical application values.     

加强的全肠外营养支持应用于恶性梗阻性黄疸术后患者的效果

Objective To investigate the effect of enhanced total parenteral nutrition support to patients after accepting surgery operation for malignant obstructive jaundice.Methods Randomly,72 cases of patients with malignant obstructive jaundice having a body capacity score of ≤4 before the operation were divided into two groups,i.e.,the enhanced total parenteral nutrition group of 36 patients,and the control group of 36 patients.For the enhanced total parenteral nutrition group,total parenteral nutrition (TPN) had been given from three days before the operation,and for the control group,TPN was given from 1 day after the operation.The following items were observed,including serum total proteins,albumin level,pre-albumin level,transferrin level,as well as the time for exhausting by anus after the operation,the occurrence rate of eomplieatious,and the days for staying in hospital after the operation.Results The observed index of the enhanced group at the third day and the 12th day are all higher than those of the control group.The time for anus exhausting between the two groups did not show a significance in statistics.And the occurrence rate of complications and the days for staying in hospital after the operation in the enhanced group were less than those of the control group.Conclusions Giving TPN to the patients with malignant obstructive jaundice three days before the operation,will help the patients recover and reduce complications and days for staying in hospital.     

加强的全肠外营养支持应用于恶性梗阻性黄疸术后患者的效果

Objective To investigate the effect of enhanced total parenteral nutrition support to patients after accepting surgery operation for malignant obstructive jaundice.Methods Randomly,72 cases of patients with malignant obstructive jaundice having a body capacity score of ≤4 before the operation were divided into two groups,i.e.,the enhanced total parenteral nutrition group of 36 patients,and the control group of 36 patients.For the enhanced total parenteral nutrition group,total parenteral nutrition (TPN) had been given from three days before the operation,and for the control group,TPN was given from 1 day after the operation.The following items were observed,including serum total proteins,albumin level,pre-albumin level,transferrin level,as well as the time for exhausting by anus after the operation,the occurrence rate of eomplieatious,and the days for staying in hospital after the operation.Results The observed index of the enhanced group at the third day and the 12th day are all higher than those of the control group.The time for anus exhausting between the two groups did not show a significance in statistics.And the occurrence rate of complications and the days for staying in hospital after the operation in the enhanced group were less than those of the control group.Conclusions Giving TPN to the patients with malignant obstructive jaundice three days before the operation,will help the patients recover and reduce complications and days for staying in hospital.     

Effect of enteral feeding ELENTAL on nutritional status of burned patients

To investigate the maitainance effect of enteral feeding ELENTAL on inteatine,liver and nutritional status of bumed patients.METHODS:30 cases of burned patients were randomly devided into ELENTAL feeding group(Egroup) and intravenous nutrition group(control,D).The whole calorie in group E were supplied by feeding elemental dist ELENTAL and those in group D were supplied by intravenous nutrition from the third day after burning.the supplemented calorie and nitrogen were equal in two groups.Before the ezperiment and on the 5th day and 10th day,blood were drawn to examine the levels of and serum transferring.RESULTS:There were no significant diference of serum lipid and serum transferring levels on the 7th day and 10th day in burned patients.CONCLUSION:ELENTAL diet can protect intestine effectively and improve nutritius status of the burned patients.     

The clinical values of ultra-early enteral nutrition combined with microecopharmaceutics on patients with severe acute pancreatitis北大核心CSCD

Objective: To analyze the clinical values of super early enteral nutrition combined with microecopharmaceutics and delayed enteral nutrition on patients with severe acute pancreatitis. Methods: Clinical data of thirty patients diagnosed as severe acute pancreatitis in our emergency department during January 2013 and December 2017 were reviewed retrospectively. Patients were divided into the treatment group (n=l5, patients given enteral nutrition combined with microecopharmaceutics within 24 h after admission) and the control group (n=15, patients given delayed enteral nutrition after 48 h of admission). Two weeks after the treatment, the serum variables of C-reactive protein, total protein, albumin, recovery time of urine and blood amylase, length of hospital stay and APACHE II score were compared between the two groups by using paired samples t test. Results: The C-reactive protein [(46.7 ± 13.1) mg/L vs. (190.72 ± 19.3) mg/L, t=10.4, P<0.01] and APACHE II score [(7.2 ± 1.9) vs. (9.3 ± 2.4), t=2.7, P<0.05] of the treatment group were significantly lower than those in the control group. The total protein [(58.1 ± 6.3)g/L vs. (52.6 ± 5.4) g/L, t=2.5, P<0.05] and albumin [(29.9 ± 3.2)g/L vs. (22.0 ± 2.8) g/L, t=7.12, P<0.01] of the treatment group were significantly higher than those in the control group. The recovery time of urine amylase [(13.2 ± 2.1)d vs. (18.7 ± 3.9)d, t=4.9, P<0.01] and blood amylase [(7.5±3.0)d vs. (11.1 ±3.4) d, r=3.1, P<0.01], and length of hospital stay[(14.9±4.5)d vs. (27.1 ± 5.3) d, t=6.9, P<0.01] were significantly shorter in the treatment group compared with those in the control group. Conclusions: Ultra-early enteral nutrition combined with microecopharmaceutics can shorten the length of hospital stay of patients with severe acute pancreatitis, and is safe and effective. © 2018 Chinese Medical Association. All rights reserved.     

肠内和肠外营养支持对重型颅脑损伤预后的疗效观察

目的 观察早期肠内营养对重型颅脑损伤患者营养支持效果及预后.方法 将40例重型颅脑损伤患者随机分成肠内营养(EN组)和肠外营养(PN组),比较两组使用营养液前、使用后7 d、14 d上臂围(MAC)、上臂肌围(MAMC)、三头肌皮脂厚度(TSF)、血清白蛋白(ALB)、血红蛋白(Hb)代谢和预后情况.结果 EN组使用后7 d、14 d上臂围(MAC)、上臂肌围(MAMC)、血清白蛋白(ALB)、血红蛋白(Hb)检验指标高于PN组,EN组好转率80%、感染性并发症40%,PN组好转率70%、感染性并发症80%.结论 重型颅脑损伤患者早期肠内营养,有保护肠粘膜屏障、减少并发症,改善患者预后的作用.     

早期肠内营养支持对脑卒中后重症吞咽障碍患者预后的影响

目的 探讨早期肠内营养支持对急性脑卒中后重症吞咽障碍患者预后的影响.方法 将符合才藤氏吞咽障碍7级评价法1级标准的139例急性脑卒中后吞咽障碍患者随机分成早期肠内营养组(EEN,n=69)和早期肠外营养组(EPN,n=70),在给予综合治疗的基础上,采用不同方法的营养支持,观察两组治疗前及治疗4w后血清白蛋白,非瘫痪侧上臂三头角肌肌围(MAMC)、三头肌皮褶厚度(TSF)等体重相关营养指标的变化及腹胀、应激性溃疡、肺部感染、病死率等临床并发症发生情况.结果 治疗4w后后,EEN组在营养学指标:血清白蛋白、TSF、MAMC、体重优于EPN组,差异有统计学意义(P<0.05),EEN组并发症发生数小于EPN组,其中并发应激性溃疡、肺部感染者差异有统计学意义(P<0.05),其余差异无统计学意义.结论 重症吞咽障碍是影响脑卒中神经功能康复的因素之一,也是加剧营养状况恶化、并发症发生的主要诱因,脑卒中合并重症吞咽困难患者早期应用肠内营养支持,可改善机体的营养状况,减少并发症发生,有利于患者的康复.     

加强营养支持在老年性痴呆合并吞咽障碍患者综合干预治疗中的作用

目的观察加强营养支持对老年性痴呆合并吞咽功能障碍病人综合干预治疗的疗效影响。方法选择合并吞咽功能障碍的老年性痴呆患者48例,随机分成瑞先组（瑞先营养支持）和对照组（普通饮食）．采取综合干预治疗后,观察患者的营养状况,指标包括：体重指数（BMI）、测量肱三头肌皮褶厚度（TSF）、上臂中围（MAC）和臂中部肌围（MAMC）,以及6个月内发生相关感染的天数及其吞咽功能的改善情况（参考洼田氏饮水试验评价分级）等相关指标变化。结果瑞先组患者在治疗后血红蛋白（Hb）、血清总蛋白（TP）、白蛋白（Alb）、BMI、TSF、MAC、MAMC、淋巴细胞计数和感染天数与治疗前比较,差异均有统计学意义（t分别=5．97、13-34、15．41、7．40、3．71、4．13、3．73、4．53、10．00,P均〈0．05）;对照组治疗后的TP、Alb、淋巴细胞计数、感染天数与治疗前比较,差异均有统计学意义（t分别=2．42、6．85、2．56、6．23,P均〈0．05）。瑞先组和对照组治疗后洼田氏饮水试验分级指标与治疗前比较,差异均有统计学意义（X。=21．89、18．32,P均〈0．05）。结论对于合并吞咽功能障碍的老年性痴呆患者,在进行综合干预的基础上,加强营养支持是提高老年痴呆患者吞咽能力．减少相关感染的有效辅助治疗方法。     

营养支持治疗对重症急性胰腺炎的影响

目的：探讨合理的营养支持方式对重症急性胰腺炎（SAP）患者营养状况及预后的影响。方法：将60例SAP患者随机分为全胃肠外营养支持（对照组）和肠内与肠外相结合营养支持（实验组）两组,对比营养支持前后两组患者的血红蛋白、总蛋白、血清白蛋白、氮平衡、血脂等生化指标,每天观察相关并发症情况。结果：实验组血清白蛋白、总蛋白、血红蛋白、氮平衡方面明显优于对照组（P〈0.05）,且并发症少。结论：肠内与肠外结合的营养支持方式可以改善SAP患者的营养状况,对SAP患者治疗有积极的作用。     

脑血管意外患者早期肠内营养治疗的护理观察

目的：探讨脑血管意外患者早期肠内营养支持的效果和临床护理观察。方法：将84例重型脑血管意外患者随机分为胃肠内营养组和胃肠外营养组各42例。观察两组营养状况指标（血红蛋白、总蛋白、血清白蛋白、血糖等）以及腹泻、腹胀、胃肠道出血、肝功能损害等并发症发生率。结果：经肠内营养支持后,患者的血红蛋白、总蛋白明显升高（P＆lt;0.05）,而完全肠外营养支持后,患者各指标差异无显著性;但肠外组应激性溃疡、高血糖、合并呼吸道感染、肝功能损害的发生率明显高于肠内组（P＆lt;0.05）。结论：重型脑血管意外患者早期肠内营养具有安全、有效且费用低等优点,在脑血管意外患者消化道功能健全的条件下可代替胃肠外营养。     

肠内营养支持对慢性阻塞性肺病急性加重期机械通气患者营养和预后的影响

目的 探讨营养支持对改善慢性阻塞性肺病急性加重期(AECOPD)机械通气患者营养状况和预后的作用。方法 采用随机对照法,将初期入选的100例AECOPD机械通气患者分成治疗组(n=50)和对照组(n=50)。治疗组于机械通气后48小时内开始给予肠内营养混悬液(能全力?)肠内营养(enteral nutrition, EN)支持,对照组给予自制流食支持治疗。观察并监测两组治疗前及治疗7 d和14 d后的营养指标：血清清蛋白(ALB)、前清蛋白(PA)、血红蛋白(Hb)、氮平衡(NB);营养状况：体重指数(BMI)、肱三头肌皮褶厚度(TSF)、上臂中间点周径(AMC);免疫指标：免疫球蛋白(IgA);临床指标：2周内脱机成功率、机械通气时间、入住ICU时间、呼吸机相关肺炎(VAP)的发生率,APACHE II评分以及观察肠内营养不耐受性：胃潴留、反流、误吸,导管相关感染等不良事件的发生情况;同时对未到达终点(死亡或放弃治疗)的患者做退出处理。结果 治疗14 d后,治疗组血清ALB、PA、NB、IgA各指标均明显提高,与治疗前及对照组相比,差异均有统计学意义(P<0.05);治疗组BM...     

早期应用肠内营养在结直肠癌患者腹腔镜术后随机对照研究

目的 观察早期肠内营养（EN）对维持和改善结直肠癌患者腹腔镜术后营养状态的影响.方法 选择结直肠癌患者腹腔镜术后进行营养支持的成年患者42例随机进入EN组和完全胃肠外营养（PN）组,每组21例,两组营养支持均等热量、等氮量.分别于术前及术后第1、7天检测营养状态指标,统计术后营养支持并发症的发生率.结果 术后第7天,EN组白蛋白为（39.8±4.2） g/L,明显高于PN组的（35.2±4.1）g/L（P =0.001）;EN组ALT水平明显低于PN组（P=0.001）;血糖为（7.2±0.4） mmol/L,明显低于PN组的（10.8±0.4） mmol/L（P =0.026）;肛门排气时间为（65.3±12.7）h,明显短于PN组的（97.4±9.4）h（P =0.001）;平均营养费用为（4851±538）元,明显少于PN组的（11 320±1170）元（P =0.000）.EN组营养支持无严重并发症发生.结论 结直肠癌患者腹腔镜术后EN是安全、经济、可行的.与PN支持相比,EN可更有效地改善术后患者的营养状态,促进肠道功能的恢复,降低住院费用,具有明显的优越性.     

早期肠内营养支持改善重型颅脑外伤患者胃肠道功能的研究

目的探讨应用预消化型短肽制剂实施早期肠内营养支持（EEN）,对重型颅脑外伤患者胃肠道功能的影响。方法将重型颅脑外伤患者随机分为研究组（n=45）和对照组（n=45）,研究组于入ICU后24～48h开始肠内营养（EN）．予预消化型短肽制剂,对照组于入ICU7d后开始EN。比较两组其入院第1、7、14天的血白蛋白（A）、血前白蛋白（PA）、血红蛋白（Hb）、肱三头肌皮皱厚度（TSF）、上臂周径（AMC）指标变化,并观察两组的胃肠道功能状况。结果入院第7天,研究组各指标较对照组下降缓慢,其中PA两组比较,差异有统计学意义（t=1．67,P〈0．05）,第14天,两组的A、PA、Hb、TSF、AMC指标有所回升,但差异均无统计学意义（t分别=1．29、1．24、0．76、0．68、1．30,P均〉0．05）。研究组较对照组的胃肠道功能障碍（上消化道出血、胃潴留、腹泻、反流）发生率低,两组间的差异有统计学意义（x^2分别=5．87、3．85、4．44、4．11,P均〈0．05）。结论预消化型短肽制剂实施EEN,能改善重型颅脑外伤患者的胃肠道功能。     

经鼻肠管肠内营养在胃癌根治术中的应用

目的探讨经鼻肠管肠内营养(EN)在胃癌根治术患者中的应用效果。方法在72例行胃癌根治术患者中,34例术后行肠外营养(PN)治疗,38例应用鼻肠管于术后早期行肠内营养(EN)治疗。结果术后EN组的血红蛋白和血清蛋白与PN组基本相同,而AKP、GGT和TB明显低于PN组。结论经鼻肠管的EN比PN更适合胃癌根治术患者的营养支持治疗。     

标准化处理流程在ICU肠内营养胃潴留患者中的应用研究

目的 探讨标准化处理流程在ICU肠内营养后胃潴留患者中的应用效果.方法 选取2018年3月至2019年2月100例接受肠内营养后并发胃潴留的ICU患者作为对照组,给予胃潴留常规处理,2019年3月至2020年2月100例接受肠内营养后并发胃潴留的ICU患者作为观察组,给予胃潴留标准化处理流程,连续干预7 d后比较两组患...