消化道重建术后早期小肠运动规律和肠内营养的作用  

The Effect of Enteral Nutrition and Gastrointestinal Motility on Early Postoperative after Gut Reconstruction

作　　者：丁森[1] 邹常林[2] 杨强[2] 周振理[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市南开医院外一科,天津300100

出　　处：《中国中西医结合外科杂志》2012年第3期223-226,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:观察消化道重建术后早期给予肠内营养对小肠动力的影响。方法:将16例接受消化道重建手术的患者随机分成肠内营养组和对照组各8例,分别给予术后早期肠内营养和普通治疗,应用全消化道动力监测系统及配套的Polygram98软件记录、分析、比较两组术后小肠动力波形的变化。结果:消化道重建术后早期所有患者的移行性复合运动(MMC)均消失,术后第一个MMC出现的时间均少于24h,两组差异无显著性。术后早期MMC的表现与正常MMC有明显不同:缺乏MMCⅡ相,仅由Ⅰ相和Ⅲ相构成;72h内MMC的周期变异逐步趋于一致。观察期内偶见逆向传导的MMC。肠内营养组的MMCⅢ相持续时间、曲线下面积、传导速度、动力指数、平均振幅等指标均高于对照组。两组的术后并发症等无显著差异。结论:消化道重建术后早期实施肠内营养可加速MMC的传导,改善MMC的收缩活动,对小肠动力有促进作用。Objective To observe the effect of early post-operative enteral feeding on gastro-intestinal mo- tility after gut reconstruction. Methods Sixteen patients undergone gut reconstruction were randomly divided into enteral nutrition （EN）group（n=8）and control group（n=8）. The migrating motor complex（MMC） was recorded by Medtronic Polygraf ID and Polygram 98 to analyze the change of intestinal wave shape. Results MMC dis- appeared at the early stage after gut reconstruction in all patients. The first MMC recurred in less than 24 h af- ter the operation, while there was no significant difference between two groups. However, MMC in EN group was very different from those in normal group, such as lack of phase Ⅱ and the variation of MMC trended to become normal during 72 h. Compared with control group, the duration time, area under the curve, transmit speed, mean swing and motility index of MMC phase Ⅲ were different in EN group. There was no difference in complications between two groups. Conclusion Early postoperative enteral feeding is helpful for rebuilding the normal gas- tro-intestinal motility. Further studies about patients＇ selections and nutrition preparations are needed.

关 键 词：消化道重建术 小肠动力 肠内营养 移行性运动复合波 

分 类 号：R656.7[医药卫生—外科学]