胰十二指肠切除术后病人对肠内联合肠外营养模式的顺应性研究  

Study on combination with enteral and parenteral nutritional supplement in patients after pancreaticoduodenectomy

作　　者：朱浩杰[1] 邬宇飞[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院外科,上海200020

出　　处：《外科理论与实践》2011年第3期293-297,共5页Journal of Surgery Concepts & Practice

摘　　要：目的:研究胰十二指肠切除术后病人对两种营养支持模式的顺应性和效果。方法:36例胰十二指肠切除术病人,男24例,女12例,中位年龄61(43～75)岁,分为两组:18例接受全肠内营养(EN),18例接受EN联合肠外营养(PN);对比两组营养支持的实施、临床表现、营养相关不良反应和实验室指标等。结果:两组病例的术后并发症发生率无统计学差异。EN联合PN组病人对EN耐受性优于单纯EN组:EN联合PN组仅1例(5.6%)因腹泻而中止EN,其余均完成EN:EN组病人9例(50%)不耐受,4例病人需减慢EN灌注速度,未完成部分由PN补足,5例不得不中止EN,完全改为PN两组病人营养等相关性指标无统计学差异。结论:EN联合PN模式更适用于胰十二指肠切除术后病人的营养支持。Objective Clinical studies have demonstrated that early postoperative enteral nutrition（EN） is questionable in its execution.Post-pancreaticoduodenectomy patients tend to suffer easily from nausea,abdominal distention,and diarrhoea,while submitted to postoperative EN.In this pilot study,we tried to select a more suitable nutritional supplement mode in post-pancreaticoduodenectomy patients.Methods Thirty-six patients were performed pancereaticoduodnectomy between Sep 2007 and Mar 2010,and were divided into 2 modes of postoperative nutritional supplement in a prospective single-centered study.Eighteen patients received only EN and 18 patients received EN combined with parenteral nutrition（EN＋PN group）.Results There were no difference in clinical characteristics and postoperative morbidity between the 2 groups.The rale of discontinuation of the EN was significantly higher in the 1st group,and the duration of enteral feeding was significantly longer in the 2nd or EN＋PN group.There was no difference in the frequency of nutrition-related index between the 2 groups.Conclusions The EN ＋PN mode is more suitable for nutritional support of the patients with pancreaticoduodenectomy.

关 键 词：肠内营养 肠内联合肠外营养 胰十二指肠切除术 

分 类 号：R459.3[医药卫生—治疗学]