非血运障碍的老年肠梗阻患者肠内营养应用的安全性

目的对具有营养风险的非血运障碍的老年肠梗阻患者，在胃肠道有效低位减压基础上分别给予肠外及肠内营养支持，探讨肠内营养的安全性。方法对老年肠梗阻患者采用内镜与x线辅助的肠梗阻导管的快速放置，进行肠道有效低位减压，改善肠道状况，恢复肠道功能，在此基础上按照给予肠外营养加肠内营养和仅给予肠外营养分组，分别观察患者临床症状的改善及肠内营养应用过程中并发症的发生，并比较两组的影像学及血常规、生化等指标变化。结果平均（24．83±7．95）min可完成肠梗阻导管放置。65．0％的患者1—2h内腹胀、腹痛情况明显缓解，27．5％患者在48h内症状完全缓解。研究组开始肠内营养时间为导管放置后（25．25±8．17）h，多数患者可耐受肠内营养。两组患者入院时各项检测指标差异无统计学意义。入院时两组前白蛋白均值低于正常，但1周后两组均达到正常值范围，组内比较差异具有统计学意义（P〈0．05），但差值的组间比较差异无统计学意义；两组患者入院时三酰甘油均值高于正常，治疗后研究组降至正常，但差值的组间比较差异无统计学意义。入院1周后再次比较两组各项检测指标，差异亦均无统计学意义。结论在胃肠道有效低位减压条件下，老年肠梗阻患者给予肠内营养是安全的。

Safety of application of enteral nutrition in non-blood circulation disorders of elderly patients with intestinal obstruction

Objective To explore the safety of enteral nutrition(EN)support in non-blood circulation disorders of elderly patients with intestinal obstruction.Methods A total of 40 patients (22 men and 18 women aged 62-84 years)with intestinal obstruction were enrolled in this study.Ileus tubes were rapidly placed in these patients with the assistance of endoscopy and X-ray.Afterwards patients were equally randomized into parenteral nutrition(PN)and EN(PN+EN)group and PN only group.The clinical outcomes and complications were recorded and compared.Results The average time for catheter placement was(24.83 4±7.95)minutes.Abdominal pain were relieved within 1-2 hours in26 pafienta(65.0%)and within 48 hours in 11 patients(27.5%).In the PN+EN group,EN was provided(25.25±8.17)hours after catheter placement,and most patients could tolerate EN.Laboratory findings were not significantly different at admission between two groups.The mean prealbumin leveh were below than normal level at admission but returned normal after one week,which were significantly different inside each group(P<0.05)but were not significantly different between these two groups.The triglyceride leveh were higher than the normal level at admission but returned normal after treatment;however,the difference between the two groups was not significant.The laboratories tests were also not significantly different between two groups one week after admission.Conclusion EN support is safe for elderly patients with intestinal obstruction after effective gastrointestinal decompression.