术后早期肠内营养和肠外营养对肠道手术预后的影响  

Comparison of effect of early enteral nutrition and parenteral nutrition on prognosis of intestinal surgery

作　　者：王宏刚[1] 娄建国 王勇[1] 田野[1] 乔纯忠[1] 刘庆宏[1] 

机构地区：[1]泰州市人民医院普外科,江苏泰州225300

出　　处：《中国老年学杂志》2017年第22期5640-5642,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金(81600434);江苏省自然科学基金(BK20160572);江苏省青年医学人才项目(QNRC2016514)

摘　　要：目的探讨肠道疾病患者手术治疗后行早期肠内营养(EN)和肠外营养(PN)的疗效。方法接受肠道手术治疗的患者根据营养支持方案分为全肠内营养支持(TEN)组和全肠外营养(TPN)组。比较两组患者的一般信息、营养状况、炎症指标、肝功能改变、胃肠道通气及排便情况、住院费用和住院时间等指标。结果术后第7天时,TEN组患者的体质量指数(BMI)、白蛋白(Alb)、总蛋白(TP)、前蛋白(PA)水平均显著高于TPN组(P<0.05);术后第1天两组患者的炎性指标均无统计学差异(P>0.05),TEN组术后第7天时的C反应蛋白(CRP)(P=0.002)和白细胞介素(IL)-6(P=0.007)水平显著低于TPN组;TPN组术后第7天时患者的谷丙转氨酶(ALT)(P<0.01)和谷草转氨酶(AST)(P<0.01)水平均高于TEN组;而TPN组患者的排气、排便时间、住院天数及住院总费用均显著高于TEN组(P<0.01)。结论肠道手术后早期EN能够改善患者营养指标、降低术后炎症水平、保护肝功能,促进胃肠功能恢复,加速患者康复。Objective To analyze the effect of early total enteral nutrition（ TEN） and total parenteral nutrition（ TPN） on prognosis of intestinal surgery.Methods Clinical data of patients with intestinal diseases receiving treatment were retrospectively analyzed.Results A total of 127 patients were retrospective analyzed. After the 7 th day of operation,BMI,Alb,TP,PA of patients in TEN group were significantly higher than those of TPN group（ P〈0. 05）,after the 1 st day of operation,there were no significant difference in markers between the two groups（ P〈0. 05）,after the 7 th day of operation,CRP（ P = 0.002） and IL-6（ P = 0.007） of patients in TEN group were significantly lower than those of TPN group,ALT and AST of patients in TEN group were significantly higher than those of TPN group（ P〈0. 01）,while evacuation time,defecation time,length of stay,hospitalization expense of patients in TPN group were significantly higher than those of TEN group（ P〈0. 01）.Conclusions TEN could improve the nutritional indicators,reduce inflammation of postoperation,protect liver function,promote gastrointestinal function recovery,accelerate patients recovery.

关 键 词：肠道手术 肠内营养 肠外营养 

分 类 号：R6[医药卫生—外科学]