短肽型肠内营养混悬液在结直肠癌患者术前肠道准备中的应用

Application of Suspension of Peptide-based Enteral Nutrition in Preoperative Bowel Preparation in Patients with Colorectal Carcinoma

目的探讨短肽型肠内营养混悬液在结直肠癌患者术前肠道准备中的应用。方法将50例行择期手术的结直肠癌患者按随机数字表法分为2组:试验组和对照组,每组25例。2组患者术前3 d均进流质饮食并口服甲硝唑和氟哌酸。在此基础上,试验组在术前灌肠前3 d口服短肽型肠内营养混悬液,进传统的流质饮食;对照组在术前灌肠前3 d采用传统的流质饮食,同时口服50%硫酸镁30 mL,至手术前晚。观察2组患者的肠道清洁度、术后有无并发症发生及术前第4天、术后第1天检测指标(淋巴细胞总数、血红蛋白、血清总蛋白、血清白蛋白、血清前蛋白、血清转铁蛋白)的变化等情况。结果试验组优良率、排气时间与对照组比较差异均无统计学意义(均P>0.05),试验组吻合口漏、切口感染、腹腔感染的发生率均明显低于对照组(均P<0.05)。试验组患者术后第1天淋巴细胞总数、血红蛋白、血清总蛋白、血清白蛋白、血清前蛋白水平与对照组比较差异均有统计学意义(均P<0.05),试验组血清转铁蛋白水平与对照组比较差异无统计学意义(P>0.05)。结论对行择期手术的结直肠癌患者在术前肠道准备中采用口服短肽型肠内营养混悬液代替传统流质饮食,能保证患者良好的肠道清洁度,改善患者营养状态,减少术后并发症。

Objective To explore the application of suspension of peptide-based enteral nutrition in preoperative bowel preparation in patients with colorectal carcinoma.Methods Fifty patients undergoing elective surgery for colorectal carcinoma were randomly divided into experimental group and control group,with 25 patients in each group.All patients received the liquid diet and the treatment with oral metronidazole and norfloxacin 3 days before surgery.On this basis,the patients in experimental group were given suspension of peptide-based enteral nutrition and traditional liquid diet 3 days before preoperative enema,and the patients in control group were given 50% magnesium sulfate（30 mL） and traditional liquid diet until the night before surgery.The intestinal cleanliness and postoperative complications were observed,and total lymphocyte count,hemoglobin,serum total protein,albumin,serum precursor protein and serum transferrin were measured on preoperative day 4 and postoperative day 1.Results There were no significant differences in the excellent rate and exhaust time between the two groups（all P0.05）.Compared with the control group,the incidence of anastomotic leakage,wound infection and abdominal infection significantly decreased in the experimental group（all P0.05）.On postoperative day 1,total lymphocyte count,hemoglobin,total serum protein,serum albumin and serum precursor protein showed significant differences between experimental group and control group（all P0.05）,but no differences in serum transferrin were found between the two groups（P0.05）.ConclusionApplication of suspension of peptide-based enteral nutrition,instead of traditional liquid diet,can ensure a good intestinal cleanliness,improve the nutritional status of patients and reduce postoperative complications in preoperative bowel preparation in patients with colorectal carcinoma.