不同营养方式对胰十二指肠切除术后患者早期康复的影响  

Influence of Different Nutritional Approach on Early Rehabilitation of Patients After Pancreatoduodenectomy

作　　者：许长涛[1] 李为民[1] 郑方[1] 戴新[1] 

机构地区：[1]解放军第309医院肝胆外科,北京100091

出　　处：《航空航天医学杂志》2011年第9期1045-1047,共3页Journal of Aerospace medicine

摘　　要：目的:通过比较早期肠内营养和静脉营养对胰十二指肠切除术后患者早期的康复情况,探讨胰十二指肠切除术后患者的合理营养支持方式。方法:胰十二指肠切除术后患者40例,随机分为肠内营养组(EN)和肠外营养组(PN),每组各20例,EN组于术后24 h予以肠内营养支持;PN组于术后行肠外营养支持治疗。两组患者分别于术前1 d和术后1、7 d测量患者体重,检测外周血白蛋白、前白蛋白、血红蛋白、转铁蛋白、淋巴细胞计数、尿素氮、肌酐、血糖、谷丙转氨酶、电解质等,记录肛门排气时间,观察术后有无吻合口漏、肺部及术野感染、腹胀、腹痛等并发症。结果:EN组肛门排气时间为(51.2±4.6)h,PN组肛门排气时间为(84.3±5.6)h,差异显著(P<0.05);首次排便时间EN组为(60.5±8.9)h,PN组为(97.1±10.6)h,差异有显著性意义(P<0.01);术后EN组患者胃肠功能恢复、体重、前白蛋白、白蛋白、转铁蛋白、血红蛋白等营养指标水平明显优于PN组,而肝、肾功能情况和电解质水平在两组之间没有差异。结论:行胰十二指肠切除术的患者在术后早期行肠内营养治疗有利于患者胃肠功能的恢复,有利于体重的维持及各项营养情况理化指标的稳定,而且不增加术后并发症的风险。Objective ： To study the best way of nutritional support for patients after pancreatoduodenectomy. Methods：40 patients after pancreatoduodenectomywere randomly divided into enteral nutrition group （ group EN,n = 20） and parenteral nutrition group （ group PN, n = 20）. The weight, albumin, prealbmnin, hemoglobin, transferrin, lymphocyte count, blood urea nitrogen, ereatinine, glucose, alanine aminotransferase, electrolyte were detected and anus exhaust time was recorded in all patients before operation and on 1 and 7 days after operation. Incidences of anastomotie leakage, i^ffection, abdominal distension and abdominal pain were obserced. Results： The anus exhaust time in group EN （51.2 ±4. 6 h） was earlier than that in group PN （97.1 ± 10. 6 h） （ P 〈 0. 05 ） , and the defecation time in group EN（60. 5±8.9） was also earlier than that in group PN（97. 1± 10. 6） （P 〈0. 01 ）. Simultaneously, the indicators of albumin, prealbumin, hemoglobin - n, transferrin, lymphocyte count, blood urea nitrogen, creatinine, glucose and alanine aminotransferase in group EN were also better than that in group PN. Concluslons：Early EN may promote the recovery of gastrointestinal function and maintain the stability of nutritional conditions. Moreover early EN does not increase the risk of postoperative complications.

关 键 词：胰十二指肠切除术:早期肠内营养 

分 类 号：R657.64[医药卫生—外科学]