贲门周围血管离断术后早期肠内外营养支持的临床研究

A clinical study on early enteral and parenteral nutritional support in patients with cirrhotic portal hypertension after pericardial devascularization

目的 比较早期肠内外营养在肝硬化门静脉高压症贲门周围血管离断术后病人支持治疗中的作用和地位。方法 4 0例贲门周围血管离断术病人按随机表分别进入肠内 (EN)或肠外 (PN)营养组 ,术后分别接受肠内外营养 ,观察两种营养方式对病人基础营养状况、内脏蛋白合成能力、肝功能、门静脉血流速度、胃肠功能、肠道细菌移位、死亡率、并发症率、住ICU时间、术后住院时间和经济消耗等方面的影响。结果 两种营养方式均能改善病人的营养状况。肠内营养术后并发症少 ,在提高门静脉血流速度 ,刺激肠道蠕动 ,防止肠道菌群移位 ,缩短住ICU和住院时间以及减少经济消耗方面优于肠外营养 ,且差异显著。

Objective To compare role of early enteral and parenteral nutritional support in patients with cirrhotic portal hypertension after pericardial devascularization. Methods After pericardial devascularization, 40 patients with cirrhotic portal hypertension were randomized into 2 groups to receive enteral (EN group) and parenteral nutritional support (PN group), respectively. The general nutrition condition, capability of producing protein, liver function, blood velocity of portal vein, gut function, bowel bacterial translocation, mortality, complication rate, the time staining in ICU, the duration of hospitalization and economic consumption were determined in all the patients and compared between the 2 groups. Results Both enteral and parenteral nutritional supports could improve the general nutrition condition in all the patients. However, patients receiving enteral nutritional support had less complications. Furthermore, enteral nutrition had better effects in accelerating blood velocity of portal vein, stimulating gut motion, preventing bowel bacterial translocation, shortening the time staining in ICU and duration of hospitalization and saving economic consumption than parenteral nutrition. Conclusions After pericardial devascularization, the patients should be treated with enteral nutritional support as early as possible.