胃大部切除患者术后两种途径胃肠外营养支持效果比较

Total parenteral nutrition in patients accepted subtotal gastrectomy:Comparison of two routes

目的观察全静脉营养液经中心静脉途径的支持效果。方法比较胃大部切除患者经中心静脉和周围静脉胃肠外营养支持手术前、后血清白蛋白含量、氮平衡以及并发症发生情况。结果患者术后应用胃肠外营养液对其白蛋白的早期恢复正常以及机体由负氮平衡转为正氮平衡,起着至关重要的作用。并且术后第14d时胃肠外营养液经中心静脉途径给予的效果明显优于周围静脉途径(P<0.01),并发症发生率前者明显低于后者。结论中心静脉胃肠外营养支持更有利于胃大部切除患者术后切口的愈合,提高机体抵抗力,促进疾病的康复。

Objective To investigate the effect of total parenteral nutrition（TPN） by the central venous route in patients accepted subtotal gastrectomy.Methods The 52 patients accepted subtotal gastrectomy were selected and randomly divided into two groups, as central venous （route） group and peripheral venous（route） group. By means of monitoring pre- and post-operative albumin content in serum, nitrogen equilibrium, and the occurrence of complications, the nutrient effects of two groups were compared. Results Total parenteral nutrition played an important role in the early recovery of albumin content and the alternation of nitrogen equilibrium from negative side to positive side in patients, who had accepted subtotal gastrectomy and post-operative administration of total parenteral nutrition. The effect was predominant by central venous route compared to by peripheral venous route on the 14th day after operation （P〈0.01）. Furthermore the occurrence rate of complications in central venot, s group was lower significantly in that peripheral venous group.Conclusion Total parenteral nutrition by central venous route is beneficial for the recovery of patients accepted subtotal gastrectomy.