腹部外科术后乳糜漏三种非手术治疗方式的疗效分析
发布时间：2019-05-07 13:47
【摘要】：目的通过对比低脂饮食(Low fat diet,LFD)、全胃肠外营养(Total parenteral nutrition,TPN)、全胃肠外营养+生长抑素(Total parenteral nutrition and somatostatin,TPN+S)三种非手术治疗方式治疗腹部外科术后乳糜漏(Chylous leakage,CL)的疗效,寻找最佳的治疗策略,以期改善患者愈后。方法通过对我院2011年6月至2016年6月35例腹部外科术后乳糜漏患者进行回顾性分析,收集其一般临床资料及相应的疗效指标,其中5例患者因不合乎纳入标准而除外。根据治疗方式的不同分成三组,共30例患者纳入分组,其中LFD组7例,TPN组10例,TPN+S组13例。比较三组患者的治疗后乳糜漏消失时间、再次正常饮食时间、拔出引流管时间及住院时间等疗效指标,p0.05为差异有统计学意义。结果治疗后乳糜漏消失时间、再次正常饮食时间、拔出引流管时间和住院时间,LFD组分别为(24.29±5.59)d,(26.43±4.93)d,(29.00±4.62)d,(32.57±4.86)d,TPN组分别为(17.10±1.20)d,(20.20±1.03)d,(23.30±1.64)d,(26.60±2.17)d,TPN+S组分别为(15.69±1.03)d,(18.77±1.01)d,(21.54±1.45)d,(24.38±1.56)d,两两比较差异均有统计学意义(P0.05)。且TPN+S组优于TPN组,TPN组优于LFD组(P0.05)。结论腹部外科术后乳糜漏是一种少见的并发症,绝大部分患者可经非手术疗法治愈,其首选治疗方案为给予全胃肠外营养+生长抑素。
[Abstract]:Objective to compare (Low fat diet,LFD (low fat diet), (Total parenteral nutrition,TPN (total parenteral nutrition) and (Total parenteral nutrition and somatostatin,TPN S (total parenteral nutrition) in the treatment of chylous leakage (Chylous leakage, after abdominal surgery. CL) to find the best treatment strategy in order to improve the recovery of patients. Methods from June 2011 to June 2016, 35 patients with chylous leakage after abdominal surgery in our hospital were retrospectively analyzed. The general clinical data and corresponding therapeutic indexes were collected. Among them, 5 patients were excluded because they did not meet the inclusion criteria. According to the different treatment methods, 30 patients were divided into three groups: LFD group (7 cases), TPN group (10 cases) and, TPN S group (13 cases). After treatment, the time of disappearance of chylous leakage, the time of re-normal diet, the time of pulling out the drainage tube and the length of hospitalization were compared among the three groups. There was significant difference between the three groups (p0.05). Results after treatment, the time of disappearance of chylous leakage, the time of normal diet, the time of pulling out the drainage tube and the length of hospitalization in LFD group were (24.29 卤5.59) d, (26.43 卤4.93) d, (29.00 卤4.62) d, (32.57 卤4.86) days, respectively. (17.10 卤1.20) d, (20.20 卤1.03) d, (23.30 卤1.64) d, (26.60 卤2.17) days in TPN group and (15.69 卤1.03) d, (18.77 卤1.01) d, (21.54 卤1.45) days in group S, respectively. (24.38 卤1.56) d, there was significant difference between the two groups (P0.05). TPN S group was better than TPN group, TPN group was better than LFD group (P0.05). Conclusion Chylous leakage after abdominal surgery is a rare complication. Most of the patients can be cured by non-operative therapy. The first choice for the treatment is to give total parenteral nutrition somatostatin.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R656
[Abstract]:Objective to compare (Low fat diet,LFD (low fat diet), (Total parenteral nutrition,TPN (total parenteral nutrition) and (Total parenteral nutrition and somatostatin,TPN S (total parenteral nutrition) in the treatment of chylous leakage (Chylous leakage, after abdominal surgery. CL) to find the best treatment strategy in order to improve the recovery of patients. Methods from June 2011 to June 2016, 35 patients with chylous leakage after abdominal surgery in our hospital were retrospectively analyzed. The general clinical data and corresponding therapeutic indexes were collected. Among them, 5 patients were excluded because they did not meet the inclusion criteria. According to the different treatment methods, 30 patients were divided into three groups: LFD group (7 cases), TPN group (10 cases) and, TPN S group (13 cases). After treatment, the time of disappearance of chylous leakage, the time of re-normal diet, the time of pulling out the drainage tube and the length of hospitalization were compared among the three groups. There was significant difference between the three groups (p0.05). Results after treatment, the time of disappearance of chylous leakage, the time of normal diet, the time of pulling out the drainage tube and the length of hospitalization in LFD group were (24.29 卤5.59) d, (26.43 卤4.93) d, (29.00 卤4.62) d, (32.57 卤4.86) days, respectively. (17.10 卤1.20) d, (20.20 卤1.03) d, (23.30 卤1.64) d, (26.60 卤2.17) days in TPN group and (15.69 卤1.03) d, (18.77 卤1.01) d, (21.54 卤1.45) days in group S, respectively. (24.38 卤1.56) d, there was significant difference between the two groups (P0.05). TPN S group was better than TPN group, TPN group was better than LFD group (P0.05). Conclusion Chylous leakage after abdominal surgery is a rare complication. Most of the patients can be cured by non-operative therapy. The first choice for the treatment is to give total parenteral nutrition somatostatin.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R656
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