经三腔喂养管行肠内营养治疗对胰十二指肠切除术后患者营养状况及胰腺功能的影响  

Effect of enteral nutrition therapy via three-lumen gastrojejunal tube on nutritional status and pancreatic function of patients after pancreaticoduodenectomy

作　　者：王婷婷 余鸿[2] 张烨[2] 张莉[1,3] WANG Ting-ting;YU Hong;ZHANG Ye;ZHANG Li(School of Nursing,Xinjiang Medical University,Urumqi 830011,China;Department of Pancreatic Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Nursing,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学护理学院,乌鲁木齐市830011 [2]新疆医科大学第一附属医院胰腺外科,乌鲁木齐市830054 [3]新疆医科大学第一附属医院护理部,乌鲁木齐市830054

出　　处：《广西医学》2020年第22期2898-2901,2912,共5页Guangxi Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2019D01C302)。

摘　　要：目的探讨经三腔喂养管行肠内营养治疗对胰十二指肠术后患者营养状况及胰腺功能的影响。方法回顾性分析行胰十二指肠切除术的80例患者的临床资料,其中术后采取常规胃管行肠内营养治疗32例(对照组),术后采用三腔喂养管行肠内营养治疗48例(观察组)。比较干预前后,两组患者一般营养状况(包括白蛋白、体质量、总蛋白及总胆红素水平)及胰腺功能情况[胰腺内分泌功能:正铜蓝蛋白(CP)、胰岛素及胰高血糖素(GLU);胰腺外分泌功能:血清脂肪酶、淀粉酶、胰蛋白酶原2(TPS-2)],并对比两组患者住院期间并发症发生情况。结果干预后,两组患者总蛋白、白蛋白、CP水平较干预前升高,总胆红素、GLU、胰岛素、脂肪酶、淀粉酶、TPS-2水平较治疗前降低,且观察组患者总蛋白、CP水平高于对照组,总胆红素、GLU、胰岛素、脂肪酶、淀粉酶、TPS-2水平低于对照组(均P<0.05)。观察组住院期间并发症总发生率低于对照组(P<0.05)。结论采用三腔喂养管对胰十二指肠切除术术后患者提供肠内营养支持,可以改善患者一般营养状况及术后胰腺功能,并降低术后并发症的发生率。Objective To investigate the effect of enteral nutrition therapy via three-lumen gastrojejunal tube on the nutritional status and pancreatic function of patients after pancreaticoduodenectomy.Methods The clinical data of 80 patients who underwent pancreaticoduodenectomy were retrospectively analyzed.Among them,32 cases who underwent enteral nutritional therapy with a common gastric tube after operation were enrolled as control group,and 48 cases who underwent enteral nutrition therapy with three-lumen gastrojejunal tube after operation as observation group.Before and after intervention,the two groups were compared with respect to general nutritional status(including albumin,body mass,total protein and total bilirubin levels)and pancreatic function(pancreatic endocrine function:ceruloplasmin[CP],insulin and glucagon[GLU];pancreatic exocrine function:serum lipase,amylase,trypsinogen 2[TPS-2]).In addition,the incidence of complications occurred during hospitalization was compared between the two groups.Results After intervention,the levels of total protein,albumin and CP were increased whereas the levels of total bilirubin,GLU,insulin,lipase,amylase and TPS-2 were decreased in both groups as compared with those before treatment,besides,the observation group exhibited higher total protein and CP levels,and lower levels of total bilirubin,GLU,insulin,lipase,amylase and TPS-2 in contrast to the control group(all P<0.05).The total incidence rate of complications during hospitalization in the observation group was lower than that in the control group(P<0.05).Conclusion The use of three-lumen gastrojejunal tube provides enteral nutritional support for patients after pancreaticoduodenectomy,which can improve general nutritional status and postoperative pancreatic function of the patients and reduce the incidence rate of postoperative complications.

关 键 词：胰十二指肠切除术 三腔喂养管 肠内营养 治疗 并发症 营养状况 胰腺功能 

分 类 号：R459.3[医药卫生—治疗学]