肠道预适应对门静脉高压症术后早期恢复质量的影响  

Effect of bowel preadaptation on the quality of early recovery after surgery for portal hypertension

作　　者：金珊珊[1] 许勤[2] JIN Shanshan;XU Qin(Hepatobiliary and Pancreatic Surgery,Huai’an First Hospital Affiliated to Nanjing Medical University,Jiangsu Province,Huai’an223000,China;College of Nursing,Nanjing Medical University,Jiangsu Province,Nanjing211166,China)

机构地区：[1]南京医科大学附属淮安第一医院肝胆胰外科,江苏淮安223000 [2]南京医科大学护理学院,江苏南京211166

出　　处：《中国医药导报》2022年第34期182-185,共4页China Medical Herald

基　　金：江苏省“333工程”科研资助项目(BRA2020069)。

摘　　要：目的探讨肠道预适应对门静脉高压症术后早期恢复质量的影响。方法选择南京医科大学附属淮安第一医院肝胆胰外科2020年4月至2021年9月诊断为门静脉高压症接受手术患者90例为研究对象,采用随机数字表法分为试验组和对照组。试验组接受肠道预适应,对照组按常规术前营养准备,比较两组术后肠道功能恢复情况及术后恢复质量。结果试验组术后腹胀、腹痛、恶心及呕吐率低于对照组,差异有统计学意义(P<0.05)。试验组首次进食流质时间及肛门恢复排气时间短于对照组,差异有统计学意义(P<0.05)。术后第5天,两组白蛋白、血清前白蛋白高于术后第1天,且试验组高于对照组,差异有统计学意义(P<0.05)。两组QoR-15评分、白细胞、C反应蛋白水平组间、时间及交互作用比较,差异有统计学意义(P<0.05)。其中,术后7 d两组QoR-15评分水平高于术后1、3 d,白细胞、C反应蛋白水平高于术后1 d,且低于术后3 d;术后3 d两组各指标高于术后1 d,差异有统计学意义(P<0.05)。术后7 d试验组QoR-15评分高于对照组,白细胞、C反应蛋白低于对照组,差异有统计学意义(P<0.05)。结论门静脉高压症患者术前肠道预适应能够降低患者术后胃肠功能障碍的发生,改善营养状态,提高早期恢复质量。Objective To investigate the impact of bowel preadaptation on the quality of early recovery after surgery for portal hypertension.Methods Ninety patients diagnosed with portal hypertension undergoing surgery from April 2020 to September 2021 in the Department of Hepatobiliary and Pancreatic Surgery,Huai’an First Hospital Affiliated to Nanjing Medical University were selected for the study and they were divided into experimental group and control group by random number table method,with 45 cases in each group.The experimental group received intestinal preadaptation,while the control group was prepared according to the conventional preoperative nutrition,and the two groups were compared in terms of postoperative intestinal function recovery and postoperative recovery quality.Results The rates of postoperative abdominal distension,abdominal pain,nausea,and vomiting in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).The time to the first feeding of fluid and the time to the resumption of anal venting in the experimental group were shorter than in the control group,and the differences were statistically significant(P<0.05).On postoperative 5 d,albumin and serum prealbumin were higher in both groups than on postoperative 1 d,while those in the experimental group were higher than those in the control group,with statistically significant differences(P<0.05).The differences were statistically significant when comparing QoR-15 scores,leukocytes,and C-reactive protein levels between groups,time,and interaction between the two groups(P<0.05).Among them,the level of QoR-15 score was higher in both groups at 7 d postoperatively than at 1 and 3 d postoperatively,while the levels of leukocytes and C-reactive protein were higher than at 1 d postoperatively and lower than at 3 d postoperatively;the indexes were higher in both groups at 3 d postoperatively than at 1 d postoperatively,and the differences were statistically significant(P<0.05).The QoR-15 s

关 键 词：高血压 门静脉 肠内营养 肠道预适应 恢复质量 

分 类 号：R473[医药卫生—护理学]