低氮低热量营养支持在老年患者腹部术后应用的临床观察

目的 探讨低氮低热量营养支持在老年腹部手术后应用的临床效果.方法 对2005年1月至2010年6月52例腹部手术后预计超过5天不能进食患者分A、B两组,A组27例给予低氮低热量肠外营养支持,B组25例进行传统肠外营养支持,比较两组的血糖水平、血浆蛋白水平以及并发症的发生率、营养药品费用.结果 经过术后7天的营养支持治疗,低氮低热量组血糖、营养药品费用明显低于传统组.低热量组血糖均值为（5.58±1.34）mmol/L,传统组血糖均值为（7.17±1.52）mmol/L,两组比较差异有显著性（P〈0.05）.低热量组营养药品费用均值（1328.6±103）元,传统组为（2396.8±152）元,两组差异有极显著性（P〈0.01）.血浆蛋白水平、术后并发症的发生率无差异.结论 低氮低热量的肠外营养支持符合老年患者腹部术后患者其代谢特点,有利于全身炎症应激反应的恢复,减少感染并发症的发生,能够安全有效地促进老年腹部术后病人的恢复.

The application of low nitrogen and low calorie parenteral nutrition support in postoperative elderly patients

Objective To explore the efficacy of low nitrogen and low calorie nutrition support in elderly patients undergoing abdominal surgery. Methods 52 patients who received abdominal surgery from January 2005 to June 2010 and were supposed not to take foods for 5 days were assigned to receive low nitrogen and low calorie parenteral nutriention ( 27 patients, group A ) or traditional parenteral nutriention ( 25 patients, group B ). Levels of blood sugar and plasma protein, incidence of complications, and costs of nutritional supplements were compared between the two groups. Results Seven days after nutritional support, the cost of nutritional supplements was significantly lower in group A than in group B( 1328.6 ±103]yuan vs2396.8 ± 152]yuan, P< 0.01 ). The mean blood sugar values differed significantly between group A and group B ( 5.58 ± 1.34]mmol/L vs 7.17 ± 1.52]mmol/L, P< 0.05 ). There were no differences in plasma protein levels and incidence of complications between the two groups. Conclusions Low nitrogen and low calorie parenteral nutriention support is beneficial for the metabolic characteristics in elderly patients undergoing abdominal surgery and for the improvement of overwhelming inflammatory responses,reduces the incidence of complications, and accelerates the recovery of postoperative patients safely and effectively.