营养支持对消化道瘘患者高代谢状态的作用

Effects of nutritional support on the hypermetabolism of patients with digestive tract fistula

目的 观察营养支持对消化道瘘并发严重腹腔感染患者高代谢状态的作用.方法 29例消化道瘘并发严重腹腔感染患者应用肠外营养4～8 d,然后进行肠内营养或肠内+肠外营养.在营养支持前、支持后第10、28天进行营养评价.结果 营养支持治疗后第10天血清前白蛋白、纤维连接蛋白显著升高(t=3.72,3.52,P<0.01);第28天体质量、血清白蛋白、转铁蛋白、前白蛋白、纤维连接蛋白明显升高,与治疗前比较差异有统计学意义(t=3.97,6.57,7.09,3.51,3.58,P<0.01).结论 营养支持能明显改善消化道瘘并发严重腹腔感染患者的高代谢状态.

Objective To investigate the effects of nutritional support on the hypermetabolism of patients with digestive tract fistula complicated with severe abdominal infection. Methods Twenty-nine patients with digestive tract fistula complicated with severe abdominal infection were administered parenteral nutrition (PN) for 4 to 8 days, and then followed by enteral nutrition (EN) or EN + PN. The body weight, serum albumin, transferrin, prealbumin, fibronectin were monitored before and on the 10th and 28th day after nutritional support. Results The levels of serum prealbumin and fibronectin were increased significantly on the 10th day after nutritional support (t = 3.72, 3.52, P <0.01). The body weight, the levels of serum albumin, transferrin, prealbumin and fibronectin were significantly higher than those before nutritional support (t=3.97, 6.57, 7.09, 3.51, 3.58, P<0.01). Conclusion Nutritional support is effective in alleviating hypermetabolism of patients with digestive tract fistula complicated with severe abdominal infection.