上腹部术后实施早期肠内营养的临床研究

目的]探讨早期肠内营养(术后4 h后)在上腹部术后应用的可行性、安全性及临床效果.方法]将60例上腹部手术后病人随机分为两组,实验组术后4 h后予肠内营养,对照组以肠外营养为主.观察术后病人肝肾功能、并发症、肠蠕动恢复时间、营养状况、电解质、切口愈合、胃管留置时间、早期下床活动时间等.结果]实验组病人在观察期间均无死亡、严重并发症及明显肝肾功能改变;与对照组比较,体重下降减缓,肠蠕动恢复及下床活动时间缩短(P＜0.05),术前白蛋白、总蛋白与术后1周变化不明显(P＞0.05).结论]上腹部术后早期应用肠内营养支持法,能刺激肠蠕动恢复,减少术后输液量,改善机体营养状态,促进病人早期下床活动和切口愈合.

A clinical investigation on providing enteral nutrition in earlier period for patients after underwent epigastrium surgery

Objective: To probe into the feasibility, safety and clinical effect of providing enteral nutrition in earlier period (4 hour after operation) for patients after underwent epigastrium surgery. Method: A total of 60 cases undergoing epigastrium surgery were randomly divided into two groups--control and test group. Patients of test group were given enteral nutrition 4 hours after operation. Patients of control group were mainly given parenteral nutrition. Then indexes including liver and renal functions, time of enterokinesia recovery, time of indwelling, and time of off-bed activities of all cases after operation were observed.Result: Patients of test group have no death, serious complication and obvious changes of renal and liver function compared with that in control group. Patients of test group underwent slower reducing of body weight, shorter times of both gastric tube indwelling and enterokinesia recovery. And off-bed activity time of test group patients was shortened (P<0.05).The average amount of fluids infusion of test group patients was reduced within 3 days after operation and the changes of serum albumin and total protein were not obvious in test group patients before and 1 week after operation (P>0.05).Conclusion:Applying enteral nutrition support in earlier period affer epigastrium surgery for patients can stimulate their recovery of enterokinesia, reduce their postoperative fluids infusion, and improve nutritional state of the body. It could encourage patients to start off-bed in early period and promote their wound healing as well.