胃肠术后早期肠内营养支持的临床研究

Early enteral nutrition after gastrointestinal surgery clinical research

胃肠手术38例，随机分为肠内营养组（EN组，18例）和肠外营养组（PN组，20例）。EN组术中将鼻肠管放置至Treitz韧带或空肠输出样下30cm处。术后第一天即开始恒速灌注能全力，量由1000ml递增至1500ml，速度由40ml／h渐增至120ml／h；PN组采用标准肠外营养。观测两组病人术前、术后第3、7天的体重、血淋巴细胞计数、HB、TP、ALB、GPT、BUN、T－Chol、K＋、Na＋、CI－、Ca2＋，以及恢复肛门排气、排便时间，不适反应，营养支持费用。结果表明，EN组恢复肛门排气时间较PN组提前10小时，排便时间提前20小时，未发现需中止灌注的并发症，各项监测指标两组间无明显差异，EN组费用为PN组的1／3。

Thirty eight cases with gastrointestinal surgery were divided at random into twogroups: enteral nutrition group (EN-group, 18 cases ) and parenteral nutrition group (PN-group. 20cases ). in EN-group the naso-intestinal tube was placed 30cm posterior to ligation Treitz or jejnn ex export loop. Nutrison was infused through it since the l,' postoperative day, the infused volume was in-'creasingly added from 1 000 ml/day to 1 500 ml/day, the infused rate was step-by-step increased from40 ml/h to 120 ml/h; in PN-group standard parenteral nutrition was performed. The body weight, LBC.HB, TP. ALB. GPT, BUN, T-Chol, K+. Na-. Cl-, Ca2+ were measured in the day before operationand on the 3td, the 7th postoperative day, the time postoperatively gaspassing. the time postoperativelystool- discharged, and the cost for nutritional support were compared. The results showed that the timepostoperatively gas-passing in Ed-group was ten hours faster than in PN-group; the time postoperatively stool-discharged in EN-group was twenty hours faster than in PN--group; the cost for nutrional support in Ed-group was 1 /3 of that in PN--group; there were no complications that were followed by stopping Nutrison infusion; other measured data in the both group were not different significantly.