双泵在胰腺癌合并糖尿病患者术后早期肠内营养中的应用  

Application Research on Double Pump for Early Enteral Nutrition in Patients with Pancreatic Cancer Combined with Diabetes Mellitus

作　　者：金如燕[1] 王笑微[1] 章赛珍[1] 蒋兰英[1] 谢兰珍[1] 王珊[1] 

机构地区：[1]金华市中心医院肝胆胰外科,浙江金华321000

出　　处：《解放军护理杂志》2009年第13期11-13,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨双泵(肠内喂养泵+胰岛素微泵)在胰腺癌合并糖尿病患者术后早期肠内营养(early enteral nut-ritio,EEN)中的应用价值。方法46例胰腺癌合并糖尿病患者,按入院先后随机分为实验组和对照组,实验组21例行早期肠内营养时应用双泵(复尔凯800肠内喂养泵,静脉胰岛素微泵),动态监测血糖变化,根据血糖值调整胰岛素用量,使血糖控制在一个相对正常范围,避免了血糖过度波动;对照组25例在恢复肛门排气后使用一次性输液器滴注肠内营养液,根据血糖值给予临时皮下注射胰岛素。检测并比较术前、术后7d血浆白蛋白、术前及营养结束后前白蛋白、平均住院日、总费用、并发症等。结果实验组血浆白蛋白下降值明显小于对照组(P<0.05)、前白蛋白上升的数值明显大于对照组(P<0.05),平均住院日、总费用也少于对照组(P<0.05)。实验组并发症少于对照组,但无统计学意义(P>0.05)。结论胰腺癌合并糖尿病患者术后早期肠内营养应用双泵,可以减少患者住院天数、降低住院总费用、减少并发症的发生,值得临床推广。Objective To investigate the application of the double-pump in patients with pancreatic cancer combined with diabetes supported by early enteral nutrition （EEN）. Methods Forty-six patients with pancreatic cancer combined with diabetes from Jan. 2005 to Jan. 2008 were randomly divided into the experimental group and the control group according to the hospitalization sequence. Twenty-one patients in the experiment group were given double pump（800 Fuerkai complex enteral feeding pumps,intravenous micro-injection insulin pump）during EEN. The levels of blood sugar were dynamically mornitored. The amount of insulin was adjusted according to the blood sugar level so that blood sugar was controled in a relatively normal range,to avoid excessive fluctuations in blood sugar. Twenty-five patients in the control group were given dripping enteral nutrition after the resumption of bowl function. The temporary subcutaneous injections of insulin were given to the control group according to their blood sugar levels. A comparison was conducted between the serum albumins measured before and after 7d of operation, the pre-operative and serum pre-albumin tested pre-operatively and at the end of nutrition support, the average length of hospital stays, the total costs and the complications. Results The serum albumin decreased significantly less in the experimental group than that in the control group （P〈0. 05）,The pre-albumin significantly increased in the experimental group the than that in the control group （P〈0. 05）. The average length of hospital stays and total costs were both less in the experimental group than those in the control group （P〈0.05）. The complications were less in the experimental group than those in the control group without significance （P〉0.05）. Conclusion The application of two-pump in patients with pancreatic cancer combined with diabetes for early postoperative enteral nutrition can reduce the length of hospital stay,total cost of hospitalization and the occurrence of complicati

关 键 词：双泵治疗 胰腺癌 糖尿病 早期肠内营养 

分 类 号：R735.9[医药卫生—肿瘤]