胰十二指肠切除术后肠内和肠外营养支持的对比研究

Comparison of enteral nutrition (EN) and parenteral nutrition (PN) support after pancreatoduodenectomy (PD)

目的对比观察胰十二指肠切除术(PD)后肠内营养(EN)和肠外营养(PN)对病人血清蛋白、体重、氮平衡、上臂周径和手术后并发症、住院时间的影响,比较二者的费用。方法46例PD患者随机分为两组:EN组(22例)术中空肠造口,术后24 h开始EN;PN组(24例)术后1 d起给予PN。两组采用等热量、等氮量方案,比较两组患者的术后营养状况变化、并发症发生率以及营养支持费用。结果PD后EN和PN均能改善患者的营养状态。EN组术后平均住院日较PN组短[(21.4±7.6)d vs (24.1±9.3)d,P>0.05]。EN组较PN组并发症发生率低,但差异不显著(P>0.05)。EN组营养支持费用则明显少于PN组[(1290.0±76.8)元vs (4072.0±146.4)元,P<0.01]。结论PD后经空肠造口管给予EN与PN一样能够达到营养支持的目的,并具有安全、费用低廉等优点。

Objective: To evaluate the influence of EN on the nutrition condition and recovery of the patients undergoing pancreato-duodenectomy comparing with PN and to compare the nutrition cost in EN group with that in PN group. Methods: Fourty-six patients underwent pancreato- duodenectomy in the hospital between January, 1999 and June, 2003. All the patients were randomly divided into EN group (22 cases) and PN group (24 cases). The program of isonitrogenous and isocaloric intake was taken in either group. The changes of nutrition condition, the rate of complications and the nutrition cost in both groups were compared with each other. Results: The mean cost of EN group was significantly less than that of PN group (P<0.01). The mean hospitalization days and the the complications of EN group was less than that of PN group, however, the differences were statistically insignificant (P>0.05). Conclusions: EN support as well as PN support can improve the nutrition condition of patients undergoing pancreatoduodenectomy, and EN possess the characters of safety and cheapness.