早期肠内营养在肝部分切除术后患者中的应用

目的探讨早期肠内营养在肝部分切除术后患者中的应用方法和效果。方法将64例肝切除术患者分为早期肠内营养(early enteral nutrition,EEN)组和肠外营养(parenteral nutrition,PN)组,每组各32例。观察患者肛门排气时间、术后1-4d胃肠减压液量、5-7d日均进食量、并发症、血清前蛋白和血清白蛋白变化情况的差异。结果 EEN组患者肛门排气时间较PN组提前;术后5-7d日均进食量多于PN组,两组比较,差异具有统计学意义(P<0.01)。两组患者并发症发生率比较,差异无统计学意义(均P>0.05)。手术前后EEN组患者血清前蛋白和白蛋白比较,差异无统计学意义(均P>0.05);PN组白蛋白比较,差异具有统计学意义(P<0.05)。结论早期肠内营养可以减轻肝部分切除术后患者的负氮平衡,维持重要脏器的功能,减少并发症的发生。良好细致的护理对成功实施肠内营养具有重要的意义。

Objective To explore the application method and effect of early enteral nutrition in these patients with hepatectomy.Methods 64 patients with hepatectomy were randomized into 2 groups：the early enteral nutrition（EEN） group and the parenteral nutrition（PN） group.The comparisons between the groups were made in terms of anal exhaust time,postoperative 1-4 d fluid amount of gastrointestinal decompression,postoperative 5-7 d daily food intake,complications,the serum prealbumin and albumin level.Results The anal exhaust time in EEN group was significantly shorter than that in PN group,postoperative 5-7 d daily food intake was significantly larger than that in the PN group（P 0.01）.No significant difference were found between the two groups concerning the diarrhea,the abdominal distension,the incidence of infective complications（P 0.05）.Conclusions EEN can reduce degree of negative nitrogen balance,maintain the function of the vital organs,and reduce the complications.Good care can play an important role in implementation of early enteral nutrition.