肝移植术后营养支持的应用

Nutritional support after liver transplantation

目的:探讨营养支持在肝移植术后治疗中的作用。方法:将2003年7月～2004年6月在我院行肝移植术后的病人随机分为肠内(EN)组和肠外(PN)组。与PN比较,分析早期EN对肝移植术后病人肝功能恢复和预防继发感染方面的作用。结果:顺利进行营养支持共59例,其中EN组和PN组分别为38例和21例;两组在一般资料上具有可比性。与PN组比较,EN组病人术后一周的白蛋白和前白蛋白恢复较好,胆汁量较多,肺炎等感染的发生率下降,发生腹泻的机会也下降。结论:①与PN比较,EN能促进肝移植术后肝功能,特别是蛋白合成功能的恢复。②与PN比较,EN能减少肝移植术后感染的发生率。③早期EN、肝移植术后是安全、有效的。

Objective To investigate the use of enteral nutrition and parenteral nutrition in the treatment of patients after liver transplantation. Methods A randomized controlled clinical trial was conducted comparing the role of early enteral nutrition(EN) with total parenteral nutrition (TPN) in 59 patients after liver transplantation. The liver functions, incidence of post-operative infection and intestinal complications associated with EN were analyzed. Results There were no statistical difference in general data between the two groups. One week post-opeation, the concentration of serum albumin, pre-albumin and the volume of bile in the group of early EN were higher than that in the TPN group, while the incidence of post-operative infection and that of diarrhea were lower in the early EN group. Conclusions Early EN can accelerate the recovery of liver function after liver transplantation compared with TPN, while it can help reduce the rate of post-operative infection.