胃肠手术后早期肠内营养的临床研究

Early post-operative enteral nutrition in patients with gastrointestinal surgery

目的探讨胃肠手术后早期肠内营养的可行性、安全性和临床效果。方法全部46例按营养方式不同分为肠内营养组（EN组，22例）和全肠外营养组（TPN组，24例）。对比分析两组在营养支持前后体重、肝肾功能、电解质、血浆蛋白和血红蛋白等指标，及胃肠道功能恢复情况、各种不良反应及营养费用。结果两组病例在研究期间无死亡，无严重并发症，肝。肾功能无明显变化。两组病人血浆白蛋白、前白蛋白和转铁蛋白水平营在养支持后明显升高（P〈0．05）。EN组肛门排气时间较TPN明显缩短（P〈0．05）。结论胃肠术后早期肠内营养支持是安全、可行的，在改善机体营养状况方面与全肠外营养无明显差别，并有促进胃肠道功能恢复的作用，且费用较低。

Objective To explore the feasibility and safety of early post-operative enteral nutri- tion for gastrointestinal surgery. Methotts Forty-six cases subject to gastrointestinal surgery were di- vided into EN group（n = 22）and total parenteral nutrition（TPN）group（n = 24）. Parameters including the body weight, the liver and renal function, electrolytes, plasma protein and Hb were measured be- {ore and after nutritional support. The complications and resumption of gastrointestinal function were observed. Results No deaths and serious complications occurred in both two groups. There was no significant change in impaired renal and liver functions. The levels of serum albumin, prealbumin, and transferrin were significantly elevated after nutritional support in both two groups （P（0. 05）. The bowel movement resumed significantly earlier in EN group than in TPN group（P〈0. 05）. Conclusion Early post-operative EN for gastrointestinal surgery patients is safe and feasible. There is no signifi- cant difference between EN and TPN in the improvement of body nutrition. EN is superior to TPN in terms of resumption of gastrointestinal function.