胃肠道疾病患者术后早期低热低氮肠外营养临床疗效分析

ANALYSIS OF THE THERAPEUTIC EFFECT OF LOW HEAT LOW NITROGEN PARENTERAL NUTRITION (PN) THERAPY ON PATIENTS AFTER OPERATION OF GASTROINTESTINAL DISORDER

目的观察胃肠道疾病患者术后早期低热低氮肠外营养(PN)的临床疗效。方法将80例胃肠道疾病术后患者随机分为普通肠外营养组和低热低氮肠外营养组,各40例。检测两组患者术前、术后第3、7天血清白蛋白(ALB)、前白蛋白(PA)、预后营养指数(PNI)、体液及细胞免疫功能指标,记录相关PN支持结果,进行比较分析。结果普通组和低热低氮组在手术后第3天ALB、PA水平及PNI均显著低于术前(p<0.05),跟普通组比较,低热低氮组的ALB、PA及PNI升高较快,在术后第7天,其ALB、PA水平、PNI均显著高于普通组(p<0.05);低热低氮组的CD3+、IgG以及普通组的CD3+、CD4+、IgG在术后3天显著低于术前,差异有统计学意义(p<0.05),术后第7天,低热低氮组IgA、IgG显著高于普通组(p<0.05);较普通PN支持,低热氮PN支持能减少胰岛素总用量、减低感染相关并发症和缩短住院时间。结论相对于普通PN,胃肠道疾病患者术后早期低热低氮PN能较快恢复ALB、PA、PNI和免疫功能指标,并能缩短住院时间,其疗效显著,值得推广。

Objective To observe the therapeutic effect of low heat low nitrogen parenteral nutrition（PN） therapy on patients after operation of gastrointestinal disorders.Methods 80 cases of gastrointestinal diseases were randomly and evenly divided into common parenteral nutrition group and the low heat low nitrogen parenteral nutrition group.The level of serum albumin（ALB）,prealbumin（PA）,prognostic nutritional index（PNI）,humoral and cellular immune function parameters of two groups of patients were determined at the time point of pre-operation,3d and 7d after operation.The results related to PN support were record.Results The ALB,PA level and PNI of both common PN group and the low heat low nitrogen PN group at 3d after surgery were significantly lower than that at pre-operation（p〈0.05）;Compared with that in common PN group,the ALB,PA,and PNI in the low heat low nitrogen PN group increased quickly.In 7d after operation,the ALB,PA and PNI were significantly higher than that in common group（p〈0.05）;In 3d after operation,the level of CD3＋ cell,IgG in low heat low nitrogen PN group,and the level of CD3＋ cell,CD4＋ cell,IgG in common PN group were significantly lower than that before surgery,the difference was statistically significant（p〈0.05）.In 7d after operation,the level of IgA,IgG in low heat low nitrogen PN group were significantly higher than that in common PN group（p〈0.05）;Compared with that in common PN group,in the low heat low nitrogen PN group,the total amount of insulin and the cases of infection-related complications were less,and hospital stay were shortened.Conclusion Gastrointestinal tract disease patients with early low heat and low nitrogen PN can quickly restore ALB,PA,PNI,and immune function and shorten hospital stay.The low heat and low nitrogen PN is efficacy and worthy in patients after operation of gastrointestinal disorders.