胃肠手术后早期肠内营养的临床研究

目的 :探讨胃肠手术后早期肠内营养的可行性及临床效果。方法 :胃肠手术后病人分成肠内营养组(EN组 ,18例 )、肠外营养组 (PN组 ,16例 )和对照组 (2 0例 ) ,EN组接受能全力肠内营养液 ,共 7天。术后第 3和第 7天测定血浆蛋白、肝肾功能、血糖、淋巴细胞计数、IgG、IgA、IgM和体重 ,临床观察肛门恢复排气、排便时间、不良反应和营养支持费用。结果 :肠内营养组血白蛋白、前白蛋白术后 7天明显升高 ,有统计学意义 (P <0 .0 1) ,肛门恢复排气排便时间明显提前 ,有统计学意义 (P <0 .0 1)。术后体重均有下降 ,研究组下降幅度明显小于对照组 ,有统计学意义 (P <0 .0 1)。其他生化指标均在正常范围内。结论 :术后早期肠内营养能促进胃肠功能恢复 ,改善营养状态 ,并且安全可行 ,营养支持费用仅为肠外营养的 1 3。

EARLY ENTERAL NUTRITION AFTER GASTROINTESTINAL SURGERY

Objective: To study the feasibility and clinical effects of early postoperative enteral nutrition support after gastrointestinal surgery. Methods: 54 cases were divided postoperatively into three groups: enteral nutrition group (EN group, 18 cases) , parenteral nutrition group (PN group, 16 cases) and control group (20 cases). The EN group received nutrient solution enterally for 7 days. Plasma protein, liver and renal functions , glucose , total lymphocyte count, IgG, IgA, IgM and body weight were detected on 3rd and 7th day postoperatively. The recovery of bowel movement, other digestive symptoms and the cost for nutritional support were observed during the period of study. Result: Serum albumin and prealbumin in the EN group were increased significantly (P<0.01) . The recovery of bowel movement in EN group was much earlier than that in PN group and control group (P<0.01). The body weights were decreased in all the three groups but it was less obvious in the EN group (P<0.01). No other significant changes were noted in the three groups. Conclusion: Early postoperative enteral nutrition probably could promote the recovery of gastrointestinal functianal state. It is safe and feasible. The cost for nutritional support in EN group was 1/3 of that in PN group.