短肽型肠内营养对胃切除术后患者营养状态和肠道耐受性的影响  

Effect of short peptide enteral nutrition on nutritional status and intestinal tolerance after gastric resection

作　　者：舒晓亮[1] 赵坚[2] 刘载道[3] 康凯[2] 于婷婷[2] 

机构地区：[1]复旦大学附属金山医院营养科,上海201508 [2]同济大学医学院 [3]中南大学湘雅医院营养科

出　　处：《上海医学》2015年第3期235-238,共4页Shanghai Medical Journal

基　　金：国家“十二五”科技支撑计划课题资助项目(2012BAI35B03)

摘　　要：目的研究国产短肽型肠内营养对胃切除术后患者营养状态和肠道耐受性的影响。方法采用双盲、随机对照研究,按随机数表将67例行胃切除术后的患者分入研究组(33例)和对照组(34例)。两组能量供给为基础能量消耗×1.1(校正系数),氮量供给为0.2g·kg-1·d-1。研究组患者给予国产短肽型肠内营养聚合剂(商品名为力存),对照组患者给予整蛋白型肠内营养聚合剂(商品名为能全力),试验期均为7d。统计基础人口学资料和临床资料,分别于术前和术后第7天观察两组患者的体重、BMI,评价肠道、肝脏和肾脏等重要脏器营养代谢状况。结果两组间患者的性别和手术方式构成、年龄、体重、BMI、营养风险评分、术后肠内营养开始时间的差异均无统计学意义(P值均>0.05)。两组治疗第7天患者的血清白蛋白和前白蛋白水平均显著高于同组治疗前(P值均<0.05),血糖、肌酐、尿素氮、总胆固醇、三酰甘油水平与同组治疗前的差异均无统计学意义(P值均>0.05)。两组间同时间点各项指标的差异均无统计学意义(P值均>0.05)。治疗期间,研究组腹泻、腹胀、腹绞痛、恶心呕吐和误吸的总发生率(54.5%,18/33)显著低于对照组(64.7%,22/34,P<0.05),研究组的腹泻发生率显著低于对照组(P<0.05),两组间腹胀、腹绞痛、恶心呕吐和误吸发生率的差异均无统计学意义(P值均>0.05)。结论国产短肽型肠内营养聚合剂(力存)可明显改善胃切除术后患者的营养状况,且胃肠道耐受性较好,是一种较安全有效的肠内营养聚合剂。Objective To study the effect of short peptide enteral nutrition on nutritional status and intestinal tolerance in patients after gastric resection. Methods A total of 67 patients after gastric resection were enrolled in the double-blind, randomized, controlled study. According to random number table, they were divided into research group （n = 33） and control group （n = 34）. Energy was given on the basis of energy consumption （BEE） multiplied by the correction coefficient of 1.1 according to Harris-Benedict formula, and nitrogen supply was 0.2 g · kg ^-1 d^-1. Short peptide enteral nutrition （revilife） and whole protein enteral nutrition （Nutrison Fibre） were given in the research group and control group for 7 days, respectively. The demographic data and clinical data were recorded. Body weight, body mass index （BMI）, nutrition metabolism of liver, kidney and gastrointestinal tract, and other important organs were detected preoperatively and on day 7 postoperatively. Results There were no significant differences in terms of gender, age, body weight, BMI, nutritional risk score, operation method, or the beginning of enteral nutrition between groups （all P 〈 0. 05）. On the 7 day after surgery, the plasma albumin （ALB） and prealbumin （PA） of two groups were significantly higher than the baseline （both P〈0. 05） however, the blood sugar（BG）, serum creatinine （Cr）, urea nitrogen （BUN）, total cholesterol （TO） and triglyceride （TG） of two groups had no significant difference with baseline levels （all P〉O. 05）. Therewas no significant differences in the indicators between two groups at the same time points （all P〉0.05）. The incidence of total adverse events （including diarrhea, abdominal distension, abdominal cramps, nausea and vomiting, and aspiration） was 54.5% （18/33） in research group, which was significantly lower than that in control group （64.7 %, 22/34, P〈0.05）. The incidence of diarrhea in research group was significantly

关 键 词：短肽型肠内营养 胃切除术 营养状态 肠道耐受 

分 类 号：R656.6[医药卫生—外科学] R459.3[医药卫生—临床医学]