胰十二指肠术后患者早期肠内营养结合不同方式回输胰液的效果观察  

Evaluation of different reinfusion methods of pancreatic juice with enteral nutrition in patients underwent pancreatoduodenectomy

作　　者：虞萍[1] 叶向红[2] 徐宇红[3] 张继红[4] 李芬[5] 

机构地区：[1]南京医科大学附属常州第二人民医院胃肠病中心一区,常州市213000 [2]南京军区南京总医院普通外科研究所 [3]南京医科大学附属常州第二人民医院护理部,常州市213000 [4]南京医科大学附属常州第二人民医院普外科大科,常州市213000 [5]南京医科大学附属常州第二人民医院胃肠病中心,常州市213000

出　　处：《中华护理杂志》2016年第11期1292-1296,共5页Chinese Journal of Nursing

摘　　要：目的 探讨胰十二指肠术后患者回输引流的胰液的最佳方案 。 方法 将 60 例接受胰十二指肠切除术的患者随机分为实验组和对照组，两组术中均留置胰腺导管引流管，术后24-48 h 给予早期肠内营养，并将引流的胰液进行回输。 实验组采用密闭、持续、恒温的胰液回输方式，对照组采用传统开放、间断、室温回输方式。 结果 实验组血清前白蛋白及转铁蛋白术后出现回升的时间早于对照组，水电解质失衡情况低于对照组。实验组胰液中胰酶含量、胰液细菌培养阳性率等各项指标均优于对照组，差异均有统计学意义（ P＜0.05 ）。 结论对胰十二指肠切除术后患者采用密闭、持续、恒温的胰液回输方式，能更好地改善患者术后营养状况，促进术后胃肠功能的恢复，减少消化液的丢失，增加早期肠内营养的耐受性。Objective To evaluate the effectiveness of pancreatic juice reinfusion with early-stage enteral nutrition （EN） in patients underwent panereatoduodenectomy（PD）. Methods Totally 60 patients underwent PD were randomly divided into the experimental group and the control group. All patients were treated with pancreatic duct drainage tube,and initiation of enteral nutrition（EN） was at 24-48h after PD,and drained pancreatic juice（PJ） was reinfused as well. For the experimental group,reinfusion of PJ was under airtight,continuous,moderately heated condition. For the control group,PJ was reinfused with open,intermittent and unheated manner. Results PA levels and TF levels increased earlier in the experimental group than the control group with statistical difference（P〈0.05）. Unbalanced hydration and electrolytic levels were less observed in the experimental group than in control group. Higher trypsin concentration levels and lower positive rates of PJ culture were observed in the experimental group with statistical difference （P〈0.05）. Time of first flatus was earlier in the experimental group after PD than the control group with statistical difference（P〈0.05）. Conclusion Reinfusion of PJ with EN after PD under airtight,continuous,moder- ately heated condition is better for patients＇ tolerance of EN and nutrition,with reduced PJ loss and earlier recovery of gut function.

关 键 词：胰十二指肠切除术 肠道营养 胰液 

分 类 号：R473.6[医药卫生—护理学]