胰十二指肠切除术后早期不同营养支持方式的临床对照研究  

Clinical study of early nutrition support after pancreaticoduodencetomy in the early period after pancreati-coduodenectomy.

作　　者：韩建明[1] 李令堂[1] 嵇武[1] 

机构地区：[1]南京军区南京总医院全军普通外科研究所,南京210002

出　　处：《中国综合临床》2007年第8期732-734,共3页Clinical Medicine of China

基　　金：军队"十五"医药卫生科研基金重点项目(O1Z011)

摘　　要：目的研究癌性阻塞性黄疸患者胰十二指肠切除术后早期不同营养支持方式的效果。方法40例胰十二指肠切除手术治疗的癌性阻塞性黄疸患者,随机分为术后早期肠内营养支持组(EN)和早期肠外营养支持组(PN),对2组治疗结果进行对比分析。结果EN、PN组患者术后体重及血中前白蛋白、白蛋白、转铁蛋白均较术前降低,EN组降低少于PN组,但差异无统计学意义。EN组氮平衡总体上优于PN组,EN组累计氮平衡为正氮平衡,PN组累计氮平衡为负氮平衡,2组间差异有统计学意义。EN对肝功能影响明显减轻,且治疗费用明显少于PN。结论术后早期EN可以更安全、有效、经济地改善癌性阻塞性黄疸患者胰十二指肠切除术后营养不良状态。Objective To evaluate the effects of different nutrition support therapies in the early period after pancreaticoduodenectomy in the patients with malignant obstructive jaundice. Methods Forty patients with malignant obstructive jaundice who received pancreaticoduodenectomy were randomized into postoperative early enteral nutrition （EN） support group and parenteral nutrition （PN） support group. The clincial date of these patients were retrospectively analyzed. Results The levels of prealbumin, albumin, transferring in the blood decreased significantly after operation in both group, but there was no significant difference between EN and PN group. Nitrogen balance was positive in EN group ,but it was negative in the PN group. EN had slighter influence on hepatic enzymes than PN. The ttherapeutic cost was less in EN group than PN. Conclusion Early EN support may ameliorate malnutrition of the patients after pancreaticoduodenectomy more safely, effectively and economically than PN.

关 键 词：胰十二指肠切除术 肠内营养 肠外营养 阻塞性黄疸 

分 类 号：R459.3[医药卫生—治疗学] R656[医药卫生—临床医学]