腹部手术患者术后早期肠外营养支持的临床研究

目的研究腹部手术患者术后早期肠外营养(PN)支持前后血液营养指标的变化,并探讨其临床意义。方法38例腹部手术患者术后分为营养组(n=20)和对照组(n=18),营养组于术后24 h内开始营养治疗,对照组不进行营养治疗,观察2组患者术前及术后第1天、第10天血液清蛋白(ALB)、前清蛋白(PA)、转铁蛋白(TRF)、免疫球蛋白(IgA、IgG、IgM)、预后营养指数(PNI)值的变化。结果(1)2组术前和术后第1天各指标比较均无显著差异(P>0.05);(2)术后第1天2组ALB、PA、TRF、IgA、IgM均显著低于术前(P<0.05),IgG、PNI有降低趋势(P>0.05);(3)术后第10天营养组ALB、PA、TRF、IgA、IgG、IgM、PNI均恢复到术前水平(P>0.05),对照组ALB、PA、TRF、IgA、IgG、IgM、PNI降低更为严重(P<0.05,P<0.01);营养组ALB、PA、TRF、IgA、IgG、IgM、PNI均明显高于对照组(P<0.05,P<0.01)。结论术后早期肠外营养支持能改善腹部手术患者术后营养状况及机体免疫功能,有助于促进术后患者康复。

Clinical study on early postoperative parenteral alimentation in patients with abdominal surgery

Objective To study the index changes and clinical significance of hemotrophic nutrition indexes before and after the early postoperative parenteral alimentation of patients with abdominal surgery. Methods Thirty eight cases of abdominal operation were randomly divided into two groups, namely PN group （20 cases） and control group （ 18 cases）, the nutritional therapy was started 24 hours after the operation. Albumin （ ALB）, prealbumin （ PA ）, transferring （ TRF）, total lymphocyte count （TLC） and immunoglobulin（ IgA, IgG, IgM） of the 38 patients were detected and compared between the two groups during preoperation and post-operation. Results （ 1 ）There was no significant difference in all indexes before operation and after operation on the first day between two groups; （2） With early postoperative parenteral nutrition, all detected indexes on PN group recovered preoperative level, and there was lower level in ALB, PA,TRF, IgM, PNI on the 10＇h day than on the first day; （3）While all detected indexes in control group decreased more greatly on the 10th day; （4） Comparison between the two groups,all detected indexes were significantly lower in the control group than in the PN group on the 10th day,and there was obvious differences on the first day and on the 10th day, respectively. Conclusion The early postoperative parenteral nutrition support can improve nutritional state and immune function and contribute to patients＇ rehabilitation.