肠瘘病人在确定性手术前行家庭肠内营养支持的效果分析  

Outcome of intestine fistula patients treated with home enteral nutrition before definitive operation

作　　者：邹志英[1] 黎介寿[1] 

机构地区：[1]第二军医大学南京临床医学院(南京军区南京总医院)解放军普通外科研究所,江苏南京210002

出　　处：《肠外与肠内营养》2008年第5期281-284,共4页Parenteral & Enteral Nutrition

摘　　要：目的:探讨肠瘘病人在确定性手术前实行家庭EN支持的效果。方法:58例肠瘘病人在病情平稳,恢复TEN后分为家庭EN支持组(家庭组,n=31)和住院EN支持组(住院组,n=27),由营养支持小组成员对两组病人进行指导、监测和随访。前瞻性观察记录两组病人EN支持天数、住院天数、住院费用以及营养支持前后体质量、体质量指数、血浆ALB、Hb和白细胞、淋巴细胞水平的变化,比较EN并发症的差异。结果:营养支持前后,两组病人营养指标均明显改善,组间差异无统计学意义(P>0.05),两组间并发症发生率的差异无统计学意义。两组营养支持时间,差异均无统计学意义(P<0.05)。家庭组家庭EN支持时间为(61.11±27.71)d。家庭组和住院组住院天数为[(60.79±17.11)dvs(119.38±46.70)d]、总治疗费用为(14.21±6.12)万元vs(18.92±7.22)万元,P<0.01。结论:在严格的指导和监测下,肠瘘病人在确定性手术前实行家庭EN安全可行,可达到住院营养同样的营养效果,同时能缩短住院天数,降低医疗费用。Objective：The purpose of this study was to assess the outcome treated with home enteral nutrition （HEN） support before definitive operation. of intestine fistula patients Methods： Fifty-eighty patients were divided into HEN support group and hospital enteral nutrition support group when their illness were stable and total enteral nutrition （TEN） were full resumed. All the patients were supervised by the members of nutrition support team. Days of TEN and hospital stay and medical cost was recorded. Plasma protein, body weight anti body mass index were measured on the first day of full enteral nutriton and the day enteral nutrition was stop for operation preparation. Results：Nutritional status of the patients improved. There was no significant difference between two groups in nutritional status, complications and duration of TEN. The time patients in HEN group stayed at home was （ 61.11 ±27.71 ） d and in hospital （60.79 ± 17.11 ） d. The cost in HEN group was less than that in hospital EN support group（ 140.21 ±61.2 vs 189.2±72.2 thousand Chinese dollar）. Conclusion：Under the close supervise of nutrition support team, HEN is of the same safety and effect and can reduce the time of hospital-stay and medical cost when compared hospital EN.

关 键 词：肠瘘 家庭护理 肠内营养支持 

分 类 号：R459.3[医药卫生—治疗学]