肝外伤术后肠内营养对肝功能的影响

目的 探讨肝外伤术后肠内营养对肝功能的影响.方法 将2005年7月至2011年3月收治65例肝外伤患者分成两组,30例术后接受肠内营养(EN组),35例术后行肠外营养(PN组),观察两组患者营养状况和肝功能恢复情况差异.结果 术后第1天两组患者营养状况及急性肝损伤指标差异无统计学意义(P>0.05),但术后第8天EN组各项指标基本达到正常值,而PN组反映肝脏功能的指标ALT、AST和PT检验值偏高,两组间差异有统计学意义(P<0.05),表明肠内营养更有利于肝功能恢复.61例患者得到随访(93.8%),随访时间于术后3～12个月,平均6个月,术后3个月肝功能基本恢复,两组间营养状况及肝功能的差异无统计学意义.结论 肝外伤术后早期使用肠内营养是一种经济、有效的营养支持手段,是改善术后肝损害的重要举措.

Clinical effect of postoperative enteral nutrition support on liver function of patients with hepatic trauma

Objective This study was undertaken to investigate the clinical effect of postoperative enteral nutrition support on liver function of patients suffered from hepatic trauma.Methods From July 2005 to March 2011,65 patients with liver trauma were randomly divided into two groups:30 patients in postoperative enteral nutrition group and 35 patients in total parenteral nutrition group.We analyzed the influence of different nutrition support for the major nutritional indices and the recovery of liver function between the two groups.Results Postoperative biochemical indicators between the enteral nutrition group and parenteral nutrition group were not significantly different(P>0.05) on the first day.But on the eighth day,all indexes which reflect the function status of the liver returned to the baseline in the enteral nutrition group,whereas indexes of ALT,AST and PT were slightly higher in the parenteral nutrition group(P<0.05).Data showed that the liver function in the enteral nutrition group recovered better.The patients were followed up for 3 to 12 months(average 6 months) in 61 cases(93.8%).The liver function returned to normal at the third month after operation.Nutrition status and liver function of the two groups were not significantly different.Conclusions Early enteral nutrition support is effective and economical for liver trauma,and it is beneficial for recovery of hepatic function.