早期肠内营养支持对肝脏切除术后老年患者的影响研究  

Effect of Early Enteral Nutrition Support on Elderly Patients After Hepatectomy

作　　者：闫红会 张二娟 徐心红 Yan Honghui;Zhang Erjuan;Xu Xinhong(Department of General Surgery,The First People’s Hospital of Pingdingshan City,Pingdingshan,Henan,467300,China)

机构地区：[1]平顶山市第一人民医院普外科,河南平顶山467300

出　　处：《黑龙江医学》2025年第2期178-180,共3页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关项目(LHGj20200909)。

摘　　要：目的:探讨早期肠内营养(EEN)支持对肝脏切除术后老年患者营养状况、肠黏膜屏障功能及肝功能的影响。方法:选取2020年3月—2022年3月平顶山市第一人民医院普外科收治的129例肝脏切除术后老年患者作为研究对象,按随机数表法将其分为传统营养组64例和肠内营养组65例。传统营养组患者接受常规营养支持干预,肠内营养组患者接受EEN支持干预,比较两组患者的营养状况、肠黏膜屏障功能、肝功能、1年生存率情况。结果:干预后,肠内营养组患者血红蛋白(Hb)、白蛋白(Alb)、转铁蛋白(TRF)、前白蛋白(PA)、红细胞(RBC)水平均高于传统营养组患者,差异均有统计学意义(t=6.091、3.864、5.337、6.807、13.193,P<0.001)。干预后,肠内营养组患者D-乳酸(D-lac)、二胺氧化酶(DAO)、内毒素(ET)水平均低于传统营养组患者,差异均有统计学意义(t=4.321、12.481、14.260,P<0.001)。干预后,肠内营养组患者天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、间接胆红素(IBIL)、D-二聚体(D-D)水平均低于传统营养组患者,差异均有统计学意义(t=2.013、26.944、3.991、2.835,P<0.001)。随访1年后,肠内营养组患者1年生存率为95.38%(62/65),高于传统营养组患者的84.38%(54/64),差异有统计学意义(t=4.313,P<0.05)。结论:EEN支持能够改善肝脏切除术后老年患者的营养状况,增强其肠黏膜屏障功能及肝功能,从而提高其生存率。Objective:To explore the effect of early enteral nutrition(EEN)support on nutritional status,intestinal mucosal barrier function and liver function in elderly patients after liver resection.Methods:A total of 129 elderly patients after liver resection in the hospital from March 2020 to March 2022 were selected as research objects,and they were divided into trational nutrition group and enteral nutrition group.64 patients in the traditional nutrition group received conventional nutrition support,and 65 patients in the enteral nutrition group received early enteral nutrition support.The nutritional status,intestinal mucosal barrier function,liver function and 1-year survival rate of the two groups were compared.Results:After intervention,the amounts of hemoglobin(Hb),albumin(Alb),transferrin(TRF),prealbumin(PA)and red blood cell(RBC)in enteral nutrition group were higher than those in traditional nutrition group,with statistically significant difference(t=6.091,3.864,5.337,6.807,13.193;P<0.001).After intervention,the levels of D-lactic acid(D-lac),diamine oxidase(DAO)and endotoxin(ET)in enteral nutrition group were lower than those in traditional nutrition group,with statistically significant difference(t=4.321,12.481,14.260;P<0.001).After intervention,the levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),indirect bilirubin(IBIL)and D-dimer(D-D)in enteral nutrition group were lower than those in traditional nutrition group,with statistically significant difference(t=2.013,26.944,3.991,2.835;P<0.001).After 1 year follow-up,the 1-year survival rate of patients in the enteral nutrition group was 95.38%(62/65),which was higher than 84.38% in the traditional nutrition group(54/64),and the difference was statistically significant(t=4.313,P<0.05).Conclusion:EEN support can improve the nutritional status of elderly patients after liver resection,enhance the intestinal mucosal barrier function and liver function,and improve the survival rate.

关 键 词：早期肠内营养 肝脏切除 营养状况 肠黏膜功能 

分 类 号：R65[医药卫生—外科学]