肠内营养在腹部术后胃瘫综合征治疗中的应用

目的:探讨肠内营养对腹部术后胃瘫综合征治疗的影响。方法:对2011年1月²012年12月两年间腹部手术后并发胃瘫的12例患者进行肠内营养支持治疗,观察患者临床表现、体重、总蛋白、白蛋白、转铁蛋白等指标的变化,同时对既往腹部手术后12例胃瘫患者以肠外营养支持治疗的资料进行回顾性分析,两组一般资料无统计学差异。评价肠内与肠外营养支持与治疗效果。结果:经治疗后患者均获痊愈。肠内营养组与肠外营养组相比,在肝功能异常、电解质紊乱和合并感染等并发症的发生比例上存在显著差异,肠内营养总体上能够减少平均胃瘫总天数、术后住院天数和住院费用,差异有统计学意义。肠内营养治疗2周及4周时检测患者的体重、血红蛋白、总蛋白、血清白蛋白、转铁蛋白均较肠外营养组明显增加,P<0.05。结论:肠内营养能促进胃肠道功能恢复,有利于机体营养状况改善,是治疗腹部手术后胃瘫的有效手段。

The Application of Enteral Nutrition in Treatment of Postsurgical Gastroparesis Syndrome

Objective： To investigate the effect of enteral nutrition treatment on postsurgical gastroparesis syndrome. Methods： 12 Patients complicated by gastric paralysis after abdominal surgery were treated with enteral nutrition from January 2011 to December 2012,the clinical manifestations, weight, total protein, albumin, transferrin, etc, were observed in patients, and compared with 12 cases of gastroparesis patients after the previous abdominal surgery treated by parenteral nutrition therapy. The effect of enteral and parenteral nutrition treatment was evaluated. Results： All patients were cured, there was significant difference in the incidence rate of abnormal liver function, electrolyte disturbances and infection and other complications between the two groups. Compared with parenteral nutrition, the enteral nutrition in general be able to reduce the average total number of days of gastroparesis, postoperative hospitalization days and hospitalization expenses, the difference was statistically significant（P0.05）. After two and four weeks with enteral nutrition therapy, the weight, hemoglobin, total protein, serum albumin, transferrin of patients were significantly increased compared with parenteral nutrition group. Conclusion： Enteral nutrition can promote the recovery of gastrointestinal function and improve the nutritional status, which is an effective method for treatment of gastroparesis after abdominal surgery.