早期肠内营养联合生长抑素治疗十二指肠损伤

Treatment of duodenal injury by early enteral nutrition combined somatostatin

目的:观察肠内营养(EN)和肠外营养(PN)支持联合生长抑素对改善十二指肠损伤后病人营养状态和预后的影响。方法:回顾性总结10年来我院收治65例十二指肠损伤病人的治疗,将资料分为三组,A组:手术+一般性治疗+生长抑素;B组:手术+PN+生长抑素;C组:手术+EN+生长抑素。统计分析三组病人的血生化指标和临床疗效。结果:①C组术后7、14 d血清前清蛋白显著高于A组(P<0.05);②B组和C组清蛋白、血红蛋白在术后7、14 d显著高于A组(P<0.05或P<0.01);③C组较B组术后并发症的发生率显著降低(P<0.05);④B组和C组术后肠瘘发生率、再手术率和病死率均较A组有所降低,但差异无显著性意义(P>0.05);⑤B组和C组术后住院时间较A组明显缩短(P<0.01),C组总费用较其他两组显著降低(P<0.01)。结论:早期肠内营养联合生长抑素治疗十二指肠损伤,可以改善病人的营养状况、缩短住院时间、降低住院费用和减少并发症的发生。

Objective：To evaluate the efficiency of enteral nutrition and parenteral nutrition combined somatostatin and the therapeutic efficacy and prognosis in the duodenal injuries. Methods：65 patients were retrospectively analyzed with duodenal injuries during a 10-year period. There were three groups by the treatment mode： group A treated with simple somatostatin and surgery, group B treated with surgery, somatostatin and parenteral nutrition, group C treated with surgery, somatostatin and enteral nutrition. The blood biochemical indicator and clinical curative effects were statistically analyzed. Results：①The level of PA at 7,14 days after operation in group C was significantly higher than in the group A （ P 〈 0.05 ） ; ②The albumin and haemoglobin in group B or C were significantly higher than those in the group A at 7,14 days after operation（P 〈0.05 or P 〈0.01 ） ; ③Postoperative complications in group C were significantly lower than in the group B （ P 〈 0.05 ） ; ④The incidences of intestinal fistula and reoperation and mortality in group B or C were lower than in the group A, but there was no significance（P 〉0.05） ; ⑤Lengths of hospital stay in group B or C were significantly shorter than in group A（P 〈0.01 ）and total cost in group C was significantly cut down than in the two other groups （ P 〈 0.01 ）. Conclusions ： Treatment by early enteral nutrition combined somatostatin for duodenal injury can efficiently ameliorate the nutrition state of the postoperative patients , shorten length of hospital stay, cut down total cost and decrease complications.