腹部术后实施鼻肠管早期肠内营养辅以肠外营养的应用研究

目的:探讨应用鼻肠管早期肠内营养辅以肠外营养对腹部术后患者的的可行性、安全性及临床效果。方法:将82例腹部术后患者随机分为实验组与对照组各41例,实验组留置鼻肠管,于术后12h后实施早期肠内营养辅以肠外营养;对照组留置鼻胃管,以肠外营养为主,等肠蠕动恢复后给予肠内营养支持。观察两组生活指标、生化指标、胃肠道恢复时间、早期下床活动时间及并发症等情况。结果:两组患者在观察期间无死亡、无严重并发症及营养代谢障碍,营养支持后7d血清蛋白呈上升趋势,但两组变化无统计学差异(P>0.05);两组血糖均较营养支持前下降,两组变化差异有统计学意义(P<0.01);实验组并发症发生率比对照组明显降低、肠蠕动恢复及下床活动时间明显缩短(均P<0.05)。结论:腹部术后鼻肠管早期肠内营养辅以场外营养能够较好的满足患者代谢需要,改善肠道功能,纠正代谢紊乱,减轻患者胃肠不耐受症状,促进患者早期下床活动,减少并发症的发生。

Early enteral nutrition supplemented with parenteral nutrition by nasal-intestinal tube for patients with abdominal surgery

Objective：To evaluate the feasibility,safety and clinical effect of enteral nutrition supplemented with parenteral nutrition by nasal-intestinal tube in patients after abdominal surgery.Methods：A total of 82 cases with abdominal surgery were randomly divided into experimental group and control group by half.Patients in the experimental group had nosal-intestinal tube retained,and the implementation of early enteral nutrition supplemented with parenteral nutrition 12 hours after the operation;while control group had parenteral nutrition with nasogastric tube,added with enteral nutrition after intestinal peristalsis recovery.Life indicators,biochemical indexes,gastrointestinal recovery time,early ambulation time and complications were observed.Results：During observation period,there were no death,serious complications and nutritional metabolic disorder in two groups.Seven days later after nutritional support,serum protein increased,without significant difference between the two groups（P 0.05）;blood glucose in two groups decreased after nutritional support the with significant difference（P0.01）.Incidence of complication was significantly lower in the experimental group than the control group（P0.05）,with significant shorter time of bowel movement recovery and ambulation（P0.05）.Conclusions：Enteral nutrition supplemented with parenteral nutrition by nasal-intestinal tube can meet the metabolic needs of patients,improve bowel function,correct metabolic disorders,reduce the symptoms of gastrointestinal intolerance,promote early ambulation of patients and reduce complications incidence.