消化系病术后经空肠造瘘实施早期肠内营养的临床研讨

1987年5月～1994年12月共收治因消化系疾病而做治疗性手术同时做空肠造瘘置管术,术后滴注要素饮食进行早期肠内营养共43例,观察代谢效应和并发症,结果发现经营养支持后血浆白蛋白、血红蛋白值均升高,负氮平衡得到纠正,伤口Ⅰ期愈合,血清淀粉酶值在正常范围,腹泻、腹胀的发生率6.9%,恶心为4.6%,但经调整滴速及浓度后,症状可以控制,病人能够接受.认为消化系疾病术后胃及十二指肠功能受到创伤的患者,经空肠造瘘置管滴注要素饮食是实施早期经肠营养值得推荐的营养支持途径.

A clincal study of early enteral nutrition through jejunostomy in postoperative patients with diseases of digestive system

From May. 1987 to Dec. 1994,43 patients with diseases of the digestive system who received therapeutic operation with jejunostomy at the same time were treated with early enteral nutrition of elementary diet dripping through jejunostomic tube. Having observed the metabolic effects, we found that serum albumin returned to normal, blood hemoglobin rose, nitrogen balance improved the value of serum amylase kept normal, and all wounds healed by first intention. Only few patients had gastrointestinal symptoms such as diarrhea, nausea and abdominal distention which could be allieviated by slowing down dripping speed or adjusting the concentration. It is considered that early enteral nutrition for the critical patients including postoperative acute hemorrhagic necrotic pancreatitis patients is helpful to repair the injured organs, modify gut immune function and improve patient's outcome.