老年患者腹部手术后肠内营养支持的效果观察

目的:探讨肠内营养(EN)支持对老年腹部手术患者恢复情况、实验室指标的影响.方法:对238例老年腹部手术患者随机分为EN组和肠外营养(PN)组,营养支持为7～9 d.观察两组患者术后恢复和并发症情况,检测所有患者术前和出院前白蛋白(PA),白蛋白( ALB),球蛋白(GLO)和血红蛋白(Hb)以及淋巴细胞数等实验室指标.结果:EN组患者排气时间、下床活动时间、引流管拔除时间、术后住院时间和并发症的发生率均低于PN组,且差异有统计学意义(P＜0.05)；出院前,EN组患者PA,ALB,GLO,Hb以及淋巴细胞数等实验室指标均较术前有所增加,并且均明显高于PN组(P＜0.05)；EN组术后并发症发生率低于PN组,差异有统计学意义(x2=8.279,P=0.004).结论:老年腹部手术患者应用EN支持后,可以有效改善机体营养状态和免疫功能,促进术后康复,减少并发症.

Enteral nutrition support in elderly patients after abdominal surgery

Objective:To investigate the effects of enteral nutrition(EN) support on the recovery process and laboratory indexes of elderly patients after abdominal surgery. Methods:Two hundred and thirty-eight elderly patients undergoing abdominal surgery were randomly divided into EN group and parenteral nutrition(PN) group,and the nutrition support was continued for 7-9 days.Postoperative recovery process and complications of the patients were observed,and the laboratory indexes such as prealbumin(PA),albumin(ALB),globulin(GlO),hemoglobin(Hb) and lymphocyte count were detected before operation and before hospital discharge. Results:The time to flatus,to ambulation and to drainage tube removal,length of hospital stay after surgery and incidence of complications of EN group were reduced compared with PN group,and all differences had statistical significances(all P<0.05).PA,ALB,GLO,Hb and lymphocyte count of EN group were increased before hospital discharge compared with those before surgery,and all the indexes were significantly higher than those of PN group(all P<0.05).The incidence of postoperative complications of EN group was lower than that of the PN group,and the difference had statistical significance(χ2=8.279,P=0.004). Conclusion:For elderly patients undergoing abdominal surgery,EN support can effectively improve their nutrition status and immune function,as well as promote postoperative recovery and reduce complications.