肝功能不全患者术后肠内营养支持的效果分析

EFFECT OF POSTOPERATIVE ENTERAL NUTRITION SUPPORTS FOR PATIENTS WITH HEPATIC INSUFFICIENCY

目的临床对照实践分析肝功能不全患者术后肠内营养支持的疗效及临床价值。方法随机抽取2010年1月-2013年12月住院部收治的72例肝功能不全患者,采取随机数字法分为EN（肠内营养）组与PN（肠外营养）组,通过术后给予两组患者不同途径的营养支持,对照分析两组患者的临床指标、肝功能变化、营养状态指标、炎性反应综合征、并发症及不良反应。结果 EN组患者给予营养支持15 d后体重明显高于PN组;住院时间方面EN组也少于PN组;给予营养支持后两组患者的肝功能均有明显改善（p〈0.05）,基本上达到正常水平,但是组间对比无明显差异性;术后第1天、第7天的营养状态指标两组患者无明显差异性（p〈0.05）,但是术后第15天,EN组的PA值明显高于PN组,EN组的CRP则明显低于PN组;另外在炎性反应指标、并发症及不良反应等方面,两组无明显差异性。结论在肝功能不全病例术后给予早期肠内营养支持,不仅可有效地改善患者营养状况、肝功能,还可明显降低临床炎性反应、并发症及不良反应率,具有较高的安全性,具有临床推广应用价值。

Objective To analyse the curative effect of postoperative enteral nutrition support and its clinical value in patients with hepatic insufficiency in controlled clinical trials. Methods 72 patients with hepatic insufficiency randomly selected from Jan. 2010 to Dec. 2013 in our hospital were divided into the enteral nutrition（ EN）group and the parenteral nutrition（ PN） group by random number table. Clinical indexes,liver function changes,nutrition state indexes,inflammatory response syndrome,complications and adverse reactions in two groups of patients were comparatively analysed through providing two groups nutritional support in different ways after surgery. Results The weight of EN group with nutrition support for 15 d was significantly higher than that of PN group. The hospital stay in EN group was shorter than that of PN group. The liver functions of two groups after nutrition support were significantly improved and basically reached the normal level（ p 〈0. 05）. But the comparison between two groups showed no obvious differences in view of postoperative nutrition state indexes（ p 〉0. 05） at days 1 and 7 postoperatively. After 15 d,prealbumin（ PA） value of EN group was obviously higher than that of PN group while the CRP of EN group was obviously lower than that of PN group. In addition,there was no significant difference in inflammatory reaction indexes,complications and adverse reactions. Conclusion Early enteral nutrition support for patients with hepatic insufficiency after surgery can not only effectively improve the nutritional status and liver function in patients,but also significantly reduce the rate of inflammatory reaction,complications and adverse reactions with higher security,thereby having clinical popularization and application value.