三腔胃肠管在胰十二指肠切除术后行早期肠内营养的应用价值

Value of early enteral nutrition through Freka Trelumina in patients after pancreaticoduodenectomy

目的:探讨胰十二指肠切除术后经三腔胃肠管行早期肠内营养的应用价值.方法:回顾性选取行胰十二指肠切除术的89例患者,将其分为静脉营养(TPN)组、三腔胃肠管(FT)组和单腔普通营养管组.两肠内营养(EN)组术后24h开始给予以百普力为主的EN,与TPN组比较体质量、白蛋白、前白蛋白和氮平衡等营养相关指标,并观察术后并发症发生率、肛门排气时间、术后住院时间和费用.同时对比两EN组置管成功率、患者出现呕吐、腹泻等不耐受情况的比例等,评价FT在胰十二指肠切除术后患者中的应用价值.结果:在用FT进行空肠肠内营养的同时进行胃内减压,能改善患者术后营养相关指标.与单腔普通营养管组相比较,并发症的发生率显著地降低了(肺部感染:7.1%vs20.0,P<0.05).恶心呕吐症状的发生率也显著降低(10.7%vs30.0%,P<0.05).与TPN组相比较,其肛门排气时间,术后住院时和住院费用都相对较少(91.2d±12.0d vs 146.1d±19.2d,14.3d±2.5d vs 18.5d±3.6d,4.1万元±1.5万元vs 5.8万元±1.3万元,均P<0.05).结论:运用FT进行肠内营养安全可靠,具有更好的耐受性和较少的并发症.

AIM：To evaluate the value of early enteral nutrition （EEN） through Freka Trelumina （FT）,a new three-lumen gastrojejunal tube,in patients after pancreaticoduodenectomy.METHODS：Eighty-nine patients undergoing pancreaticoduodenectomy were divided into three groups：total parenteral nutrition （TPN） group （n=31）,one-lumen tube group （nasojejunal or nasogastric tube,n=30） and FT group （n=28）.Parenteral nutrition were given to the TPN group patients by superior vena cava catheterization before the operation,while the patients in the two EN groups were given EEN from the first day after the operation.RESULTS：Nutritional parameters were improved postoperatively in patients receiving EN through FT and decompression of the stomach.Compared with the one-lumen tube group,the incidence of complications （lung infection：7.1% vs 20.0,P0.05） and nausea/vomiting was significantly lower （10.7% vs 30.0%,P0.05） in the FT group.Compared with the TPN group,the time required to restore anal exhaust,the duration of postoperative hospitalization,and the cost were significantly lower in the FT group （91.2 d±12.0 d vs 146.1 d±19.2 d,14.3 d±2.5 d vs 18.5 d±3.6 d;4.1 million yuan±1.5 million yuan vs 5.8 million yuan±1.3 million yuan,all P0.05）.CONCLUSION：EEN through FT is feasible and safe in patients after pancreaticoduodenectomy.