个体化阶段性营养支持治疗上消化道高位瘘的临床研究  

Treatment of upper gastrointestinal fistula with personal stage nutritional support

作　　者：汪群[1] 刘志苏[1] 钱群[1] 孙权[1] 潘定宇[1] 

机构地区：[1]武汉大学中南医院普外科,430071

出　　处：《临床外科杂志》2007年第10期666-668,共3页Journal of Clinical Surgery

摘　　要：目的探讨上消化道高位瘘患者采取个体化阶段性营养支持治疗的可行性。方法43例由于外伤以及胃、十二指肠手术后发生高位肠瘘的患者随机分为个体化阶段性营养支持治疗组28例(A组)和全胃肠外营养组15例(total parental nutrition TPN,B组)。观察术前、术后1、15、30d两组患者血浆白蛋白、转铁蛋白、前白蛋白、氮平衡、淋巴计数作为患者营养状况的评价指标。测定患者的ALT、AST、总胆红素的值作为肝功能评价的指标,观察他们各自并发症、平均住院时间和经费。结果观察期内A组患者的营养状况、肝功能优于B组(P<0.01)。A组患者出现并发症和费用少于B组患者(P<0.01)。结论采用个体化阶段性营养支持治疗的方法治疗更有利于患者的恢复,减轻肝脏的负荷,减少并发症,缩短患者的住院时间,减少费用,是一种治疗上消化道高位瘘可行的方法。Objective To investigate the feasibility of treatment by personal stage nutritional support for patients with upper gastrointestinal fistula. Methods Forty - three patients with upper gastrointestinal fistula due to trauma and operations of stomach and duodenum were randomly divided into group A receiving personal stage nutritional support and group B subject to total parental nutrition （TPN）. The nutritional levels of two groups were evaluated by determining serum Alb, TSF, pre - Alb, nitrogen balance and counts of lymphocytes, and hepatic.functions were evaluated by measurement of AST,ALT,total bilirubin （TB） before and 1,15 and 30 days after operation. The complications,mean hospital stay and expenditure were surveyed. Results The nutrition and hepatic function of the patients in group A were superior to those in group B （ P 〈 0.01 ）. The incidence of complications was low- er and hospital expenditure less in group A than in group B （ P 〈 0.01 ）. Conclusion The treatment of personal stage nutritional support was feasible for upper gastrointestinal fistula, more beneficial for the post - operative recovery and more economic.

关 键 词：阶段性营养支持 营养状况 上消化道高位瘘 

分 类 号：R656.6[医药卫生—外科学]