膳食纤维在胃肠道肿瘤术后肠内营养中应用的临床观察

目的:探讨膳食纤维(DF)在胃肠道肿瘤术后病人肠内营养中的应用及其对腹泻的影响.方法:将32例胃肠道肿瘤术后病人,分为含膳食纤维肠内营养组(FSF组)和不含膳食纤维肠内营养组(FFF组),每组16例.于肠道功能恢复后开始行肠内营养支持,连续6天.观察病人腹胀、腹痛、恶心、呕吐等胃肠道症状,使用Hart and Dobb腹泻量表记录每天排便情况.术前及肠内营养结束后第2天,空腹测定血常规、肝肾功能、前清蛋白、转铁蛋白.结果:两组病人腹泻评分最高都出现于肠内营养第4天,FSF组平均评分和总腹泻天数均低于FFF组(P＜0.05),腹泻发生率无显著性差异(P＞0.05),FSF组腹胀发生率较FFF组高(P＜0.05).两组术后清蛋白、前清蛋白、转铁蛋白和淋巴细胞总数均有显著下降(P＜0.05),组间比较无显著性差异.结论:胃肠道肿瘤术后病人含DF肠内营养,对维持机体重要脏器功能和营养状态与不含DF肠内营养效果相似,但耐受性更好,可缩短肠内营养过程中腹泻天数、降低腹泻严重程度.

Usefulness of Fiber-supplemented Enteral Formula in Postoperative Patients with Gastrointestinal Neoplasm

Objectives: To explore the clinical effects of enteral nutrition with dietary fiber on diarrhea and nutritional status in postoperative patients withgastrointestinal neoplasm. Methods: Thirty two patients withgastrointestinal neoplasm were separated into fiber supplemented formula group ( n =16) and fiber free formula group ( n =10)following operation. Diarrhea was assessed with Hart and Dobb diarrhea score daily. A series parameters including blood cell count, renal and liver functions, electrolytes, prealbumin and transferrin were measured before and after nutritional therapy. Results: The fiber supplemented formula group had less days with diarrhea (7/90 vs 17/90, P < 0.05 ) and a lower mean diarrhea score (4.79 6.18 vs 7.44 7.85, P <0.05), but a higher occurrence of flatulence. The nutritional status were similar. Conclusions: Enteral nutrition supplemented with dietary fiber is beneficial in reducing the days with diarrhea and improving the character of stool.