肝功能不全病人术后早期肠内营养的临床应用

目的观察肝功能不全病人术后早期肠内营养疗效及安全性。方法肝功能不全病人52例，随机分成肠内营养组（26例）及肠外营养组（26例）。术前及术后第1、4、7天监测谷丙转氨酶、谷草转氨酶、胆红素及营养代谢指标。记录并发证、术后肠道恢复通气时间、术后住院时间和营养治疗费用。结果两组谷丙转氨酶、谷草转氨酶变化差异无显著性（P〉0.05）；肠内营养组胆红素下降速度较肠外营养组快；胃肠道功能恢复时间肠内营养组明显早于肠外营养组（P〈0．01）；两组住院时间差异无显著性（P〉0.05）；肠内营养组治疗费用约为肠外营养组的1／4。结论肝功能不全病人术后早期肠内营养是安全而有效的，可有效改善病人的营养状况；减少并发症的发生；可加快降低高胆红素血症者的胆红素水平。具有促进胃肠道功能恢复和降低治疗费用的优势。

Clinical application of the early enteral nutrition for hepatic inadequacy patients after operation

Objective] This study was designed to investigate the clinical effects and safety in hepatic inadequacy patients. Methods] A series of 52 hepatic inadequacy patients were investigated. These patients were randomly divided into enteral nutrition (EN) group and parenteral nutriton (PN) group. ALT, AST, BIL, indicatrix of nutrition and metabolism were detected before operation, the 1th day, the 4th day and 7th day after operation. Complication, resumption of gastrointestinal function, time in hospital after operation and medical cost were recorded. Results] The level of ALT, AST in EN group did not decline more obviously than that in PN group; BIL in EN group decreased more quickly than in PN group (P <0.05); Time of resumption of gastrointestinal function in EN group was earlier that in PN group (P <0.01); Time in hospital of EN group did not decline more obviously than that in PN group; EN group was a quarter of PN group in the medical cost. Conclusions] Enteral nutrition is safe and effective support method to hepatic inadequacy patients after operation, and can improve the nutrition state of patients, promote resumption of gastrointestinal function, decrease the level of BIL and reduce the medical cost.