经内镜逆行胰胆管造影围手术期营养支持的误区

目的 探讨经内镜逆行胰胆管造影(ERCP)围手术期营养支持的合理性.方法 对2003年4月-2008年10月期间,对首都医科大学附属北京同仁医院普外科收住的采用内镜进行ERCP诊断和治疗的114例患者进行回顾性分析,分析ERCP围手术期营养支持的临床价值及并发症.结果 内镜进行ERCP诊断和治疗患者114例,其中46例患者围手术期给予脂肪乳、氨基酸等肠外营养支持(营养支持组),68例仅给予常规糖电解质输液(常规输液组);63例患者术后禁食12 h,51例患者术后禁食24 h.营养支持组和常规输液组在术后住院天数、并发症的发生数均无明显性差异,但住院费用营养支持组明显高于常规输液组;术后禁食12 h组与术后禁食24 h组在术后住院天数、住院费用和并发症的发生数均无明显性差异.114例患者围手术期无死亡病例.结论 ERCP围手术期营养支持没必要过量使用,对于成功完成ERCP的患者,术后早期进食是安全的.

Misusage of perioperative nutritional support in patients with endoscopic retrograde cholangiopancreatography

Objective To evaluate the effects of nutritional support in patients with ERCP.Methods One hundred and fourteen in patients with ERCP From Apr.2003 to Oct.2008 were reviewed retrospectively,and the clinical value and complications of nutritional support were evaluated.Results One hundred fourteen inpatients examined with ERCP,were divided into two groups;parenteral group(re = 46)and electrolytes treatment group(re = 68).There were no significant difference in length of hospital stay and postoperative complications between the two groups.Electrolytes treatment group had lower relevant hospital cost.Sixty-three patients were fasting 12 hours(eating group),and 51 patients were fasting 24 hours(fasting group).There were no significant difference in cost,length of hospital stay,postoperative complications between the two groups.Conclusions The rate of parenteral nutrition in patients with ERCP were relatively higher,the application of parenteral nutrition was unnecessarily overdose;Early enteral nutrition is safe in successful operating patients.