规范化序贯肠内肠外营养支持疗法与肠外营养支持对于胃肠道手术后患者的疗效对照研究  

Comparison of clinical efficacy between standardized sequential enteral-parenteral nutrition support and total parenteral nutrition support in patients undergoing gastrointestinal surgery

作　　者：张国鹏 孙姜鹰 赵洪浩 

机构地区：[1]山东省冠县人民医院普外科,山东聊城252500

出　　处：《实用临床医药杂志》2012年第11期34-36,39,共4页Journal of Clinical Medicine in Practice

摘　　要：目的对照研究规范化序贯早期肠内肠外营养支持疗法(EEN+PN)与肠外营养支持(TPN)对胃肠道手术后患者的临床疗效。方法 136例拟行开腹胃肠道手术的患者随机分为EEN+PN组(n=72)和TPN组(n=64),分别于术前、术后第3、7天监测并比较代表性营养相关指标、生化相关指标以及免疫及炎症指标,记录并比较2组患者术后恢复、营养支持疗法费用以及住院时间。结果 EEN+PN组在术后第7天的白蛋白明显高于TPN组,EEN+PN组在术后第3、7天的前白蛋白明显高于TPN组,EEN+PN组术后第7天淋巴细胞计数显著高于TPN组,EEN+PN组首次排气时间、住院时间均明显短于TPN组,营养支持相关费用明显低于TPN组。结论胃肠道手术后规范化序贯早期肠内肠外营养支持疗法可以改善机体营养状态及免疫功能,有利于患者的术后恢复,有效保护胃肠道功能,降低营养支持疗法相关费用,缩短住院时间。Objective To compare the clinical efficacy of standardized sequential early enteral nutrition（EEN） support and total parenteral nutrition（TPN） support for patients with gastrointestinal surgery.Methods A total of 136 patients undergoing open gastrointestinal surgery were randomly divided into EEN＋PN group（n=72） and TPN group（n=64）.The nutrition related indicators,biochemistry related indicators,and immune and inflammatory indicators were recorded and compared before surgery and at day 3 and day 7 after surgery.The postoperative recovery,the cost of nutrition support scheme and hospital stay in both groups were recorded and compared.Results The level of albumin in EEN＋PN group at day 7 after surgery was significantly higher than that in the TPN group.The level of pre-albumin in EEN＋PN group at day 3 and day 7 after surgery was significantly higher than that in the TPN group.The lymphocyte count in EEN＋PN group at day 7 after surgery was significantly higher than that in the TPN group.The first flatulence and hospital stay in EEN＋PN group were significantly shorter than those in the TPN group,and the nutrition support related costs were significantly lower than that in the TPN group.Conclusion The standardized sequential early EEN＋PN therapy can improve the nutritional status and immune function,contribute to patient postoperative recovery,effectively protect the gastrointestinal tract function,reduce associated costs of the nutrition support,and shorten hospital stay.

关 键 词：胃肠道手术 营养支持 早期 肠内营养 肠外营养 

分 类 号：R735.2[医药卫生—肿瘤]