中药和肠内营养在胰十二指肠切除术后早期应用研究

目的探讨中药和肠内营养在胰十二指肠切除术后早期应用的意义.方法41例胰十二指肠切除患者分为治疗和对照两组.治疗组22例,术后早期小肠内滴注中药,待肠鸣音恢复后同时滴注营养液;对照组19例,术后早期不用中药,待肠鸣音恢复后同样滴注营养液,两组供给热量和氮量相同.术后分别观察两组胃液胆汁胰液引流量、胃肠功能恢复情况、营养状况改善、免疫功能提高和术后并发症发生率.结果术后1～3d两组平均消化液引流量无显著差别(P＞0.05);4～6d治疗组平均消化液引流量略高于对照组,但无统计学意义(P＞0.05);7～9d两组平均消化液引流量无显著差别(P＞0.05).治疗组术后胃肠功能恢复明显早于对照组(P＜0.05～0.01);治疗组术后第14d营养状况和免疫功能较术后第1d明显改善(P＜0.05～0.01);治疗组术后并发症发生率也明显低于对照组(P＜0.05).结论胰十二指肠切除术后早期实施中药和肠内营养支持治疗,有助于胃肠功能的早日恢复、营养状况的改善和免疫功能的提高,并有助于减少术后并发症的发生.

Study on Early Application of Chinese Medicinal Herbs and Enteral Nutrition after Pancreaticoduodenectomy

Objective:To evaluate the effect of early application of Chinese medicinal herbs and enteral nutrition after pancreaticoduodenectomy Methods:Fourty-one patients of pancreaticoduodenectomy were divided into two groups.A silicon catheter was inserted via the nose through the stomach into the proximal jejunum for fluid administration postoperatively.Twenty-two of them(treated group)were given via the catheter Chinese medicinal herbs during the early postoperative period and the control group was not given herbs.While a bowel movement occurred,enteral nutrition was administered in either group.Two groups were given isocaloric and isonitrogen during the perioperative period.The daily digestive juice output,the digestive function and nutritional status,immune function and postoperative complications of the two groups were observed and analyzed.Results:The mean digestive juice output of the two groups were significantly different within 1 to 9 days postoperatively(P>005).The digestive function of the treated group recovered rapidly.The nutritional status and the immune function of the treated group improved markedly as compared with those of the control(P<005-001),and the postoperative complications were less than those of the control(P<005).Conclusion:Early application of Chinese medicinal herbs and enteral nutrition after pancreaticoduodenectomy can promote the digestive tract to recover and improve the nutritional status and immune function,and can reduce morbidity.