胰十二指肠切除术后联合营养支持临床分析

Combined nutritional support with enteral nutrition and parenteral nutrition after pancreaticoduodenectomy

目的:探讨肠内营养+肠外营养(EN+PN)支持对维持和改善手术创伤术后患者营养状态的效果。方法:选择胰十二指肠切除术后需行营养支持的16例患者,随机分PN组及EN+PN组。两组营养支持均等热量、等氮量。营养支持前、手术后12 d测血清白蛋白、胆固醇和胆红素含量。结果:①EN+PN组白蛋白、血清胆固醇含量高于PN组,但无显著差异(P>0.05)。②EN+PN组血胆红素、胆汁酸比PN组明显改善(P<0.05)。结论:与PN支持相比,EN+PN可较早期有效地改善术后患者的营养状态。应根据术后患者的具体情况,合理早期应用EN。

Objective：To evaluate the efficiency of enteral nutrition and parenteral nutrition in postoperative patients receiving pancreaticoduodenectomy. Methods： Sixteen patients who underwent pancreaticoduodenectomy and required nutritional support were randomized into two groups： parenteral nutrition （PN） group and enteral＋ parenteral nutrition （ EN ＋ PN） group. The intake of calorie and nitrogen was unified in every patient depending on patient＇s body weight. The serum albumin, cholesterin and bilirubin levels before operation and 10 days after operation were detected. Results： The albumin and cholesterin levels were higher in the EN ＋PN group than those in the PN group, but there was no significant difference between the two groups（P 〉 0.05 ）. The changes of serum bilirubin in the PN group were significantly lower than those in the EN ＋ PN group （ P 〈 0.05 ）. Conclusion ： Compared with PN support, EN＋ PN support can efficiently ameliorate the nutrition status of postoperative patients. In postopeartive patients, early enteral nutrition should be recommended.