Whipple术后空肠造口营养液两种输入法应用比较  

Clinical effect of two kinds of infusion jejunum nutrition colostomy of patients after Whipple operation

作　　者：贾世峰[1] 闫丰[1] 朱红成[1] 焦桂梅[1] 刘博[2] 

机构地区：[1]河北联合大学附属医院肿瘤外科,河北省唐山市063000 [2]解放军总医院肝胆外科

出　　处：《中国综合临床》2015年第1期6-9,共4页Clinical Medicine of China

基　　金：唐山市科技计划项目（13130270Z）

摘　　要：目的比较Whipple术后经空肠造口采用营养输注泵进行肠内营养的疗效及降低患者不良反应发生的临床效果。方法选取河北联合大学附属医院2009年2月至2013年11月期间实施的Whipple术并空肠造口患者65例，按不同的营养液输入方法分为观察组（33例）和对照组（32例）。观察组患者用营养输注泵泵入（15～50ml／h）；对照组采用一次性输液器连接输液器，调节滴速为30滴／min，24h更换1次输液器，均采用恒温器加热及温开水冲管，比较两组患者术后血糖、血白蛋白、血电解质浓度、输入营养液期间不良反应及术后出现呕吐、腹胀、腹泻等不良情况。结果术后第1、3、5天血糖比较差异均无统计学意义（F组内=3．01，P〉0．05；F组间=2．90，P〉0．05；F交互=2．87，P〉0．05）；术后第1、3、5天血白蛋白比较，差异均无统计学意义（F组内=2．94，P〉0．05；F组间=2．89，P〉0．05；F交互=2．76，P〉0．05）；术后第1、3、5天血Cl-比较差异无统计学意义（F组内=1．78，P〉0．05；F组间=1．96，P〉0．05；F交互=1．88，P〉0．05）；术后第1、3、5天血Na＋比较，差异均无统计学意义（F组内=1．06，P〉0．05；F组间=1．35，P〉0．05；F交互=1．27，P〉0．05）；术后第1、3、5天血K＋比较差异无统计学意义（F组内=3．12，P〉0．05；F组间=3．04，P〉0．05；F交互=2793，P〉0．05）。两组患者呕吐、腹胀、腹泻的发生率差异均有统计学意义（x2值分别为4．029、4．381、4．905，P均〈0．05）。结论Whipple术后空肠造口采用输注泵进行肠内营养，在减少术后出现呕吐、腹胀、腹泻等不良情况与经输液器输注肠内营养比较有较好的临床效果，术后血糖、血白蛋白及血电解质浓度无明显差异。Objective To compare the effect of enteral nutrition by jejunum colostomy nutrition infusion pump of patients after Whipple surgery as well as reduce adverse reactions in patients. Methods Sixty-five cases with the implementation of Whipple and jejunum of colostomy were selected as our subjects, who were hospitalized in the Affiliated hospital of Hebei United University from Feb. 2009 to Nov. 2013. All patients were divided into observation group （33 cases） and control group （32 cases） according to the methods of nutrient input. Patients in observation group were given nutrition infusion pump pumping （15 to 50 ml/h） ;and patients in control group were adopted disposable infusion connection infusion with the speed of 30 drops/rain with the thermostat heating temperature and the water pipe. The blood glucose, serum albumin, blood electrolyte concentration of postoperative, and the adverse reactions during input nutrient solution including vomiting, abdominal distention,diarrhea and other adverse circumstance were recorded. Results At lst,3rd,5th day, there was no statistically significant difference in terms of the levels of glucose, blood albumin, blood Cl, Na＋ , K＋ between two groups （ blood glucose ： F inner grouP = 3.01, P 〉 0. 05 ; F between group = 2. 90, P 〉 0. 05 ; F cross group = 2. 87, P 〉 0. 05 ; serum albumin ： F inner group = 2. 94, P 〉 0. 05 ; F between group = 2. 89, P 〉 0. 05 ; F cross group = 2. 76, P 〉 0. 05 ; blood Cl： F inner group = 1.78, P 〉 0. 05 ; F between group = 1.96, P 〉0. 05 ;F cross group = 1.88 ,P 〉0.05 ;blood Na ＋ ：F inner group = 1.06 ,P 〉0.05 ;F between group = 1.35, P 〉 0. 05 ; F cross group = 1.27,P 〉 0. 05 ; blood K＋ ： F inner group = 3.12, P 〉 0. 05 ; F between group = 3.04, P 〉 O. 05;F cross group = 2. 93, P 〉 0. 05 ）. There were significant differences regarding of the rate of vomiting, abdominal distention, diarrhea and other adverse conditions compared with the infusion enteral nutrition has good clinical effec

关 键 词：WHIPPLE术 营养输注泵 肠内营养 

分 类 号：R573[医药卫生—消化系统]