术后早期肠内营养和肠外营养对肠道手术预后的影响

发布时间：2018-01-01 07:21

本文关键词：术后早期肠内营养和肠外营养对肠道手术预后的影响　出处：《中国老年学杂志》2017年22期 　论文类型：期刊论文

【摘要】：目的探讨肠道疾病患者手术治疗后行早期肠内营养(EN)和肠外营养(PN)的疗效。方法接受肠道手术治疗的患者根据营养支持方案分为全肠内营养支持(TEN)组和全肠外营养(TPN)组。比较两组患者的一般信息、营养状况、炎症指标、肝功能改变、胃肠道通气及排便情况、住院费用和住院时间等指标。结果术后第7天时,TEN组患者的体质量指数(BMI)、白蛋白(Alb)、总蛋白(TP)、前蛋白(PA)水平均显著高于TPN组(P0.05);术后第1天两组患者的炎性指标均无统计学差异(P0.05),TEN组术后第7天时的C反应蛋白(CRP)(P=0.002)和白细胞介素(IL)-6(P=0.007)水平显著低于TPN组;TPN组术后第7天时患者的谷丙转氨酶(ALT)(P0.01)和谷草转氨酶(AST)(P0.01)水平均高于TEN组;而TPN组患者的排气、排便时间、住院天数及住院总费用均显著高于TEN组(P0.01)。结论肠道手术后早期EN能够改善患者营养指标、降低术后炎症水平、保护肝功能,促进胃肠功能恢复,加速患者康复。
[Abstract]:Objective to evaluate the efficacy of early enteral nutrition (en) and parenteral nutrition (PNN) in patients with intestinal diseases after surgical treatment. The general information of the two groups was compared with that of the total parenteral nutrition (TPN) group and the total parenteral nutrition (TPN) group. Nutritional status, inflammation index, liver function change, gastrointestinal ventilation and defecation, hospitalization cost and hospitalization time. Results on the 7th day after operation, the body mass index (BMI) of the patients in TEN group was determined. The levels of Alb, TPN and PPA in TPN group were significantly higher than those in TPN group (P 0.05). On the first day after operation, there was no significant difference in inflammatory indexes between the two groups (P 0.05). On the 7th day after operation, the levels of C-reactive protein (CRP) and interleukin-6 (IL-6) P0. 007) in TEN group were significantly lower than those in TPN group. On the 7th day after operation, the levels of alanine aminotransferase (alt) and aspartate aminotransferase (AST) in TPN group were higher than those in TEN group. However, the exhaust, defecation time, hospitalization days and total hospitalization cost in TPN group were significantly higher than those in TEN group (P 0.01). Conclusion en can improve nutritional index of patients after intestinal operation. Reduce postoperative inflammatory level, protect liver function, promote gastrointestinal function recovery, accelerate the recovery of patients.
【作者单位】：泰州市人民医院普外科;
【基金】：国家自然科学基金(81600434) 江苏省自然科学基金(BK20160572) 江苏省青年医学人才项目(QNRC2016514)
【分类号】：R459.3;R656
【正文快照】： 肠道疾病患者营养不良的发生率非常高,尤其是在手术或是伴随感染等严重应激状况下,机体常常处于一种高分解代谢状态,蛋白质合成远不如分解,负氮平衡的现象很常见,从而出现低蛋白血症,引起机体免疫力下降,因而伴发感染的概率大大升高,严重影响预后。胃肠道功能维持与否与机体的

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