早期微量肠内营养对先天性胃壁肌层缺损术后恢复的影响  

Effect of early enteral nutrition on postoperative treatment of congenital defects of gastric musculature

作　　者：欧文辉[1] 段守兴[1] 符马贤 陈凯宏 李建宏[1] Ou Wenhui;Duan Shouxing;Fu Maxian;Chen Kaihong;Li Jianhong(Second Affiliated Hospital,Shantou University Medical College,Dongxia North Road,Shantou City,Guangdong Province,China)

机构地区：[1]汕头大学医学院第二附属医院小儿外科,广东省汕头市515000

出　　处：《临床小儿外科杂志》2021年第3期263-267,共5页Journal of Clinical Pediatric Surgery

基　　金：汕头市科技计划项目(编号:汕府科[2017]182号-34)。

摘　　要：目的探讨早期微量肠内营养对先天性胃壁肌层缺损术后恢复的影响。方法回顾性分析2003年6月至2018年6月汕头大学医学院第二附属医院收治的23例先天性胃壁肌层缺损患者的临床资料,根据术中是否留置空肠营养管分为早期肠内营养组(n=12)和常规喂养组(n=11),对比两组术后的营养状况、电解质酸解平衡及术后恢复情况。结果与常规喂养组相比,早期肠内营养组患者术后7 d血清K+浓度(t=3.740,P=0.001)、Ca^(2+)浓度(t=5.829,P<0.001)及pH值(t=4.772,P<0.001)的变化差异均有统计学意义;而血红蛋白(t=1.403,P=0.177)、血清白蛋白(t=1.105,P=0.283)、载脂蛋白A(t=0.125,P=0.902)、载脂蛋白B(t=0.527,P=0.604)等营养性指标的变化差异均无统计学意义;与常规喂养组相比,早期肠内营养组的体重增长幅度更大(t=2.210,P=0.040),首次排便时间更短(t=10.051,P<0.001),两组吻合口瘘发生率及病死率差异均无统计学意义(P>0.05)。结论先天性胃壁肌层缺损术后实行早期微量肠内营养可加速患者体重增长及肠功能恢复的进程,并有助于维持机体电解质及酸碱平衡,值得临床推广。Objective To explore the effect of early enteral nutrition on postoperative treatment of congenital defects of gastric musculature.Methods Retrospective reviews were conducted for 23 cases of congenital defect of gastric musculature from June 2003 to June 2018.They were divided into two groups of early enteral nutrition and routine.The authors collected and compared the postoperative data of these two groups,including postoperative nutritional status,electrolyte acidolysis balance and postoperative recovery.Results As compared with routine feeding group,K+(t=3.740;P=0.001),Ca^(2+)(t=5.829;P<0.001)levels and pH(t=4.772;P<0.001)in early enteral nutrition group after 1 week were statistically significant(P<0.05).And such nutritional indicators as hemoglobin(t=1.403;P=0.177),serum albumin(t=1.105;P=0.283),apolipoprotein A(t=0.125;P=0.902)and apolipoprotein B(t=0.527;P=0.604)were not statistically significant(P>0.05);Weight gain(t=2.210;P=0.040)and time of initial defecation(t=10.051;P<0.001)were statistically significant in early enteral nutrition group(P<0.05)as compared with those in routine feeding group.The incidence of anastomotic fistula and mortality were not statistically significant(P>0.05).Conclusion For congenital defects of gastric musculature,early postoperative enteral nutrition can accelerate weight growth and intestinal function recovery and maintain the electrolyte and acid-base balances.It is worthy of clinical promotions.

关 键 词：胃壁肌层缺损/先天性 肠道营养 治疗结果 婴儿 新生 

分 类 号：R726.1[医药卫生—儿科] R574[医药卫生—临床医学]