围手术期联合营养支持在克罗恩病治疗中的应用

目的 观察围手术期联合营养支持对克罗恩病患者的治疗效果.方法 回顾总结2000年1月至2008年6月165例行围手术期营养支持的克罗恩病患者的资料.按营养支持方式的不同分为全肠内营养支持组、全肠外营养支持组、联合营养支持组,每组各55例,各组入院后除营养支持外其余治疗措施无明显差异,比较联合营养支持与全肠内营养支持、全肠外营养支持的效果.结果 与全肠内营养支持、全肠外营养支持组相比,联合营养支持组围手术期热卡供应较充足,短期内营养状况的改善较明显,前白蛋白、转铁蛋白、淋巴细胞、血小板明显升高;联合营养支持组疾病缓解率为80.0%,高于全肠内营养支持、全肠外营养支持组的76.4%和74.5%;联合营养支持组手术并发症发生率为10.9%,明显低于全肠内营养支持、全肠外营养支持组的25.4%和18.2%;联合营养支持组住院时间相对缩短,住院费用较少.结论 对于围手术期克罗恩病患者,联合营养支持的治疗效果明显优于全肠内营养支持与全肠外营养支持.

Effects of perioperative combined nutritional support in Crahn disease

Objective To observe the efficacy of perioperative combined nutritional support in patients with Crohn disease.Methods From January 2000 to June 2008,165 patients with Crohn disease receiving perioperative nutritional support were included in this retrospective analysis.The patients were divided into three groups according to the ways of nutritional support: total enteral nutrition group,total parenteral nutrition group and combined nutrition group;there were 55 patients in each group.Each group had the same treatment except for nutritional support.The efficacy of different approaches of nutritionalsupport was analyzed and compared among the groups.Results Compared with total enteral and total parenteral nutrition,combined nutrition supplied more sufficient energy,the nutritional status improved more significant in short time;pre-albumin,transferrin,lymphocytes and platelet count increased significantly.The disease remission rate in combined nutrition group was 80.0%,better than 76.4% in total enteral nutrition group and 74.5% in total parenteral nutrition group.The morbidity rate was 10.9% in combined nutrition group,and it was lower than that in total enteral nutrition group and total parenteral nutrition group (25.4% and 18.2%,respectively).The length of hospital stay was shorter and the treatment was more cost-effective in combined nutrition group.Conclusion For patients with Crohn disease,perioperative combined nutritional support is more efficient than total enteral or parental nutrition support.