胆汁回输联合肠内营养在恶性梗阻性黄疸患者减黄治疗中的应用  

Effect of External Biliary Recycle Combined with Enteral Nutrition on the Treatment of the Malignant Obstructive Jaundice

作　　者：赵加应[1] 蔡元坤[1] 程志俭[1] 任重[1] 廖晓寰[2] 徐火根[2] 程明荣[1] 李方明[1] 

机构地区：[1]复旦大学附属上海市第五人民医院普外科,上海200240 [2]复旦大学附属上海市第五人民医院检验科,上海200240

出　　处：《中国临床医学》2007年第6期817-819,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:观察应用胆汁回输联合肠内营养对恶性梗阻性黄疸患者减黄治疗后的影响。方法:回顾总结60例恶性梗阻性黄疸行姑息性减黄治疗患者的临床资料,其中胆汁回输组23例,单纯外引流组18例,内引流组19例,分别检测术前当天、术后第6、10天丙氨酸氨基转移酶(ALT)、总胆红素(TB)、血清白蛋白(Alb)、前白蛋白(PA)、内毒素(ET)、肿瘤坏死因子(TNF-α)、可溶性白细胞介素2受体(sIL-2R)水平,比较3组并发症发生率、住院时间和治疗费用等指标。结果:①术后3组患者ALT、TH、ET、TNF-α、sIL-2R较术前明显降低,术后第6天胆汁回输组明显低于外引流组和内引流组,术后第10天内引流组与胆汁回输组无显著差异,但两组均低于外引流组(P<0.05)。②术后3组患者Alb和PA较术前明显升高,术后第6天胆汁回输组高于外引流组和内引流组,中术后第10天内引流组与胆汁回输组无显著差异,但两组均高于外引流组(P<0.05)。③并发症发生率、住院时间、治疗费用胆汁回输组低于外引流组和内引流组(P<0.05)。结论:胆汁回输联合肠内营养符合生理.能更快地改善恶性梗阻性黄疸患者减黄治疗后的营养状况,促进肝功能的恢复.减轻炎症反应.增强免疫力.降低并发症发生.减少治疗费用。胆汁回输联合肠内营养具有简单、安全、有效、价廉的临床应用价值。Objective：To observe the effects of the application of external bile recycle combined with enteral nutrition for the treatment of malignant obstructive jaundice. Methods： The Chinical data of 60 cases with malignant obstructive jaundice treated in our hospital were analyzed retrospectively . All the cases were divided into bile recycle group（23 cases）, simple external drainage group（18 cases） and enternal drainage group （ 19 cases）. ALT, TB, serum albumin, prealbumin, ET, TNF-α and slL- 2R were detected on the operation day, the 6^th day and the 10^th day after operation respectively. Results： （1）The 3 groups inde xes of ALT,TB,ET, TNF-αand sIL-2R fell down after operations. But the 6 days after operations these indexes in the bile recycle group were lower than other 2 groups. On the 10^th day after operations, these indexes in enternal drainage group were e qual to those which in bile recycle group, and these indexes in simple external drainage group were higher than other 2 groups （P〈0.05）.（2）The 3 groups indexes of serum albumin and prealbumin rise after operations. But the 6th day after operations these indexes in the bile recycle group were higher than other 2 groups. On the 10^th day after operations these indexes in enter nal drainage group were equal to those which in bile recycle group, these indexes in simple external drainage group were lower than other 2 groups （P〈0.05）.（3）In the bile recycle group the complication occurrence, the time of hospitalization and cost were lower than other 2 groups（P〈0.05）. Conclusion：Bile recycle can improve the nutritional condition of the patients suffering from malignant obstructive jaundice more effectively and more quickly. It can also promote the restore of the hepatic function, alleviate inflammatory reaction, increase the immune activity, low down the occurrence of complication and the cost. External bile recycle combined with enteral nutrition has the significant clinical value which is simple, safe, effective a

关 键 词：胆汁回输 肠内营养 恶性梗阻性黄疸 

分 类 号：R459.3[医药卫生—治疗学]