不同营养支持在腹部外科术后患者中的应用

目的研究腹部外科术后营养不良的患者肠内营养（EN）与肠外营养（PN）支持的临床效果,为临床营养支持的选择提供参考。方法回顾性调查我院经腹部外科术后营养不良的患者187例,比较其营养支持前后营养指标的变化及住院天数等的差异。结果 3组患者的体重、Hbs、ALB、PA和TRE均有不同程度的降低。PN组和EN组、EN＋PN组分别比较差异均有统计学意义（P〈0.05）,EN组和EN＋PN组比较差异无统计学意义（P〉0.05）。结论腹部外科术后EN安全、有效,能维护机体代谢平衡,减少或避免术后感染性并发症方面有一定优势。

Application of different nutritional support route in patients undergoing major abdominal surgery

Objective To investigate the clinical effect of enteral nutrition（EN） and parenteral nutrition（PN） in patients undergoing major abdominal surgery,and provide reference to clinical practice.Methods Retrospetive study of 187 patients undergoing major abdominal surgery were conducted in ICU ward,gastrointestinal surgery,genneral surgery and urology surgery of our hospital in January 2008 to June 2010.Patients were divided into EN,PN or EN＋PN group according the nutritional route.Nutritional index,as well as the changes in the number of days hospitalized were compared with each other.Results The level of body weight,Hb,sALB,PA and TRE were descend in three groups.Compared to PN,EN and EN＋PN were significant difference of descend content（P0.05）.There was no obviously difference between EN and EN＋PN（P0.05）.Conclusion EN after abdominal surgery seems to be safe and effective,produces a positive nitrogen balance,keeps the integrality of structure and functions of the apparatus,protects gut barrier,and reduces or prevents septic complications.