营养支持对体外循环术后患者营养状态的影响

目的：探讨营养支持对体外循环（CPB）术后患者营养状态的影响。方法：60例体外循环术后患者随机分为两组：对照组和营养支持组，每组30例。对照组自由进食，营养支持组在自由进食基础上，每日额外口服营养液750ml，时间为1周。对两组患者术前、术后的人体测量指标（体重、三头肌皮褶厚度、上臂围、臂肌围）及血浆蛋白（血清白蛋白、前白蛋白、转铁蛋白）、血红蛋白和总淋巴细胞数等指标进行测定。结果：两组患者术后1天各项指标均下降（P＜0．05）。术后8天，除总淋巴细胞数外，对照组各项指标与术前间差异显著（P＜0．01），感染性并发症的发生率达13．3％；营养支持组术后8天血浆蛋白含量与对照组差异有显著性意义（P＜0．005），无感染性并发症发生。结论：CPB心内直视手术能明显影响机体的营养状态，术后早期肠内营养支持能改善营养状态，减少感染性并发症的发生，缩短恢复时间。

The effect of nutrition support on nutritional status in patient of cardiopulmonary bypass

Objective To investigate the effect of nutrition support on nutritional status in patients of cardiopulmonary bypass (CPB).Methods Sixty patients having valve replacement for rheumatic heart valvular disease were randomly divided into two groups:control group and nutrition support group,30 cases in each group.Control group ate freely,nutrition support group took orally 750ml nutritional fluid every day on basic of eating freely,last for one week.Anthropometry (WT,TSF,AC,MAC),Visceral protein(ALB,PA,TF),Hemoglobin (Hb),Total lymphocyte count (TLC) were calculated before and after CPB.Results On 1st day after CPB,all indexes were decreased quickly in two groups (P<005).On 8th days,all indexes except TLC were decreased significantly in control group(P<001),Visceral protein level were increased significantly in nutrition support group than that in control group(P<0005).The infectious complication rat was up to 133%(4/30) in control group.Conclusion The results demonstrate that open heart operations in which CPB in used are responsible for the variation of nutritional status of patients,nutrition support can improve nutritional status in patients of CPB,reduce infectious complication and shorter the time of recovery.