腹部手术后早期肠内营养对患者肝功能及肠黏膜屏障功能的影响

[目的]探讨早期肠内营养应用在腹部手术患者中对肝脏功能与肠黏膜屏障功能的影响.[方法]选择2011年5月～2014年5月我院行腹部手术的患者90例,采取随机数字表法分为观察组和对照组,对照组给予肠外营养支持,观察组给予肠内营养支持,观察2组肝功能与肠黏膜屏障功能的变化.[结果]观察组干预后丙氨酸氨基转移酶（20.93±10.73）U/L,门冬氨酸氨基转移酶（24.46±11.54） U/L,总胆红素（36.85±17.03）μmol/L;对照组干预后丙氨酸氨基转移酶（21.61±11.65） U/L,门冬氨酸氨基转移酶（24.78±11.94） U/L,总胆红素（36.98±17.21）上mol/L,组间比较差异无统计学意义（t=0.2880、0.1293、0.0360;P＞0.05）.观察组干预后内毒素（0.22±0.05） EU/ml,D-乳酸（8.23±2.01）mg/L,尿L/M比值（0.06±0.01）;对照组干预后内毒素（0.35±0.14） EU/ml,D-乳酸（12.31±3.14）mg/L,尿L/M比值（0.13±0.05）,干预后组间比较差异有统计学意义（t=5.8662、7.3411、9.2091;P＜0.05）.观察组术后排气时间（20.38±4.15）h,住院时间（13.26±1.89）d,并发症发生率为4.44％;对照组术后排气时间（29.67±6.92）h,住院时间（19.75±2.86）d,并发症发生率为17.78％,干预后组间比较差异有统计学意义（t或x2=7.7233、12.6999、4.0500;P＜0.05）.[结论]对腹部手术患者早期应用肠内营养可以防止患者肠通透性降低,保护患者肠黏膜,减少手术并发症发生,值得在临床上大力推广使用.

Clinical effect of early enteral nutrition on the influence of liver function and intestinal mueosal barrier function of abdominal surgery patients

[Objective]To explore the protective effect of early enteral nutrition on liver function and intestinal mucosa barrier in patients after abdominal surgery.[Methods]Ninety patients with abdominal surgery were divided into observation group and control group by the method of random number table,control group was given parenteral nutrition support,observation group was given enteral nutrition support,and then observe the liver function and the change of the intestinal mucosal barrier function.[Results]Observation group after the intervention the alanine aminotransferase was（20.93 ± 10.73）U/L,aspartate transaminase was（24.46±11.54）U/L,total bilirubin was（36.85±17.03）μmol/L;control group after the intervention the alanine aminotransferase was（21.61 ± 11.65） U/L,aspartate transaminase was（24.78 ± 11.94）U/L,total bilirubin was （36.98±17.21）gmol/L.There was no statistically significant difference between two groups（t=0.2880,0.1293,0.0360,P〉0.05）.Observation group after the intervention the endotoxin （0.22±0.05）EU/ml,D-lactic acid（8.23±2.01）mg/L,urine L/M ratio（0.06±0.01） ;the control group after the intervention the endoto xin （0.35 ± 0.14） EU/ml,D-lactic acid （12.31 ± 3.14） mg/L,urine L/M ratio （0.13±0.05）;There was statistically significant difference between two groups （t =5.8662,7.3411,9.2091 ; P〈 0.05）.Observation group after the intervention the exhaust time was （20.38 ± 4.15） h,the length of stay was（13.26±1.89）d,the incidence of complications was 4.44% ;in control group after the intervention the exhaust time was（29.67±6.92）h,the length of stay was（19.75±2.86）d,the incidence of complications was 17.78%,There was statistically significant difference between two groups（t or x2=7.7233,12.6999,4.0500 ; P 〈 0.05）.[Conclusion] Enteral nutrition can prevent intestinal permeability in patients with abdominal surgery,protect the intestinal mucosa barrier and decrease infectious complication after operation,It is worth to pop