早期肠内营养在防治体外循环心脏术后急性胃肠损伤中的价值  

The Value of Early Enteral Nutrition in the Prevention of Acute Gastrointestinal Injury After Heart of Postoperative of Extracorporeal Circulation

作　　者：黄治家[1,2] 吴昆鹏[1,2] 陈莹[1,2] 言彩红[1,2] 

机构地区：[1]南华大学附属第二医院重症医学科,衡阳421001 [2]南华大学附属第二医院麻醉科,衡阳421001

出　　处：《内蒙古医学杂志》2017年第3期262-265,共4页Inner Mongolia Medical Journal

摘　　要：目的探讨早期肠内营养在体外循环心脏术后急性胃肠损伤防治中的价值。方法回顾性分析2010年1月至2013年3月342例体外循环心脏术后患者,其中鼻饲组200例术后即在胃镜下置入鼻空肠管,术后数小时循环稳定就可开始经肠管小剂量燕麦米汤输注;常规组142例按常规待拔气管插管后评估胃肠功能再进食,对比分析两组患者AGI发生率、住院时间、ICU滞留时间、总死亡率等。结果术后鼻饲组发生AGI 4例,常规组9例,两组发生AGI率有明显差异(χ2=4.27,P=0.035),鼻饲组患者ICU滞留时间及总住院时间较常规组减少(P<0.05),总死亡率没有差别(χ2=0.06,P=0.659);已发生的AGI患者中鼻饲组临床症状改善较常规组快(P<0.05),但死亡率没有差别(χ2=0.41,P=0.538)。结论早期肠内营养能有效减轻体外循环心脏术后AGI发生率,能快速减轻AGI患者临床症状,促进恢复。Objective To discuss the value of early enteral nutrition in acute gastrointestinal injury after heart postoperative of extracorporeal circulation.Methods Clinical data for 342 patients with heart postoperative of extracorporeal circulation from January 2010 to March 2013 were retrospectively analyzed.The research group,200 cases of postoperative namely in nasal jejunal tube under gastroscope,infusion oats rice water after circulition stability;The control group,142 cases eating throgh assessment of gastrointestinal function after pull out endotracheal intubation,compared two groups of patients the incidence of AGI,length of hospital stay,ICU stay time,total mortality,etc.Result 4cases of postoperative in the research group,and 9cases AGI in the control group,two groups of AGI rate have obvious difference（χ2=4.27,P=0.035）.The time stay in ICU and hospital stay was reduced in the research group（P〈0.05）,mortality rates has no diffenerce（χ2=0.06,P=0.659）.The AGI patients clinical symptoms improved faster in the research group than the control group（P〈0.05）,mortality rates has no diffenerce（χ2=0.41,P=0.538）.Conclusion Early enteral nutrition can reduce the AGI after heart postoperative of extracorporeal circulation effectively,can relieve AGI patients clinical symptoms quickly.

关 键 词：肠内营养 体外循环 急性胃肠损伤 

分 类 号：R656.6[医药卫生—外科学]