肝移植术后肠内营养时机选择的探讨

目的 探讨肝移植术后肠内营养的恰当时机.方法 将2005年6月至2006年7月实施原位肝移植术的46例患者随机分为实验组(术后第1天给予肠内营养)和常规组(患者肛门排气、胃肠道功能恢复后给予肠内营养),各23例,比较两组患者的术后感染率、胃肠道功能恢复情况、ICU监护时间、营养费用及并发症发生率.结果 实验组患者肝移植术后肺部感染率、导管源性感染率、营养费用均显著低于常规组(P＜0.05或P＜0.01);胃肠道功能恢复时间、ICU监护时间较常规组短(P＜0.01);并发症发生率和腹腔感染率两组无统计学差异(P＞0.05).结论 肝移植术后第1天给予肠内营养可有效降低肺部和导管源性感染率,促进胃肠道功能恢复,缩短ICU监护时间,降低营养费用.

A Study on the Timing of Enteral Nutrition in Patients after Liver Transplantation

Objective To understand the best timing for enteral nutrition in patients after liver transplantation.Methods Forty-six patients who received orthotopic liver transplantation from June 2005 to July 2006 were evenly randomized into experimental group(enteral nutrition was give 1 day after operation) and conventional group(enteral nutrition was give after anus gas and recovery of gastrointestinal function).The incidence of post-operation infection,recovery of gastrointestinal function,the duration of ICU,nutritional expenses,and complications were compared between the two groups.Results The incidences of pulmonary infection and catheter-related infection and nutritional expenses in the experimental group were significantly lower than those of the conventional group(P<0.05 or P<0.01);the recovery period of gastrointestinal function and the duration of ICU were significantly shorter in the experimental group(P<0.01);there was no statistical difference in complications and the incidences of abdominal infections between the two groups(P>0.05).Conclusion Giving enteral nutrition on the first day after liver transplantation can effectively reduce the incidences of pulmonary and catheter-related infections,promote the recovery of gastrointestinal function,shorten the duration of ICU,and decrease the nutritional expenses.