早期肠内营养在严重腹部创伤患者的临床应用

Early use of enteral nutrition for patients with abdominal trauma

目的评价早期肠内营养在严重腹部创伤患者中的临床应用。方法40例严重腹部损伤患者随机分为研究组和对照组。研究组术后24h开始经空肠造瘘管给予营养液，对照组术后给予肠外营养治疗。观察两组患者用药期间的不良反应、感染性并发症、治疗前后的营养状况以及有关生化结果的改变。结果两组患者术后未发现明显不良反应和感染性并发症。两组治疗前后的体重改变差异无统计学意义（P〉0．05）。研究组和对照组术后肝、肾功能指标比较，差异无统计学意义（P〉0．05），而研究组术后血红蛋白、血清白蛋白、前白蛋白、转铁蛋白水平与对照组比较，差异有统计学意义（P〈0．05）。结论早期肠内营养在严重胃肠道创伤患者中应用优于肠外营养。

Objective To evaluate the clinical efficiency of early use of enteral nutrition in patients with abdominal trauma. Methods The patients with abdominal trauma were equally randomized to enteral nutrition group and parenteral nutrition group. Enteral nutrition was given for enteral nutrition group 24 hours postoperatively through jejunostomy, and parenteral nutrition was given for parenteral nutrition group postoperatively. Side effects, infectious complications, nutritional state before and after treatment as well as biochemical changes were observed. Results In both groups, no side effects such as diarrhea, nausea, vomiting, phlebitis and infectious complications were found. The change of body weight before and after treatment showed no statistical difference in both groups （ P 〉 0.05 ）. Liver enzymes and uric acid were normal in both groups, with no statistical difference between both groups （ P 〉 0.05 ）. The levels of hemoglobin, serum albumin, prealbumin and transferrin in enteral nutrition group were statistically different compared with those in parenteral nutrition group （P 〈 0. 05）. Conclusion Early use of enteral nutrition is superior to parenteral nutrition for patients with abdominal trauma.