腹部手术后患者早期肠内营养支持治疗效果观察

Early enteral nutrition versus parenteral nutrition in postoperative patients of abdominal surgery

目的探讨腹部手术后患者早期肠内营养（EEN）支持治疗的可行性。方法将40例中等腹部手术后患者，随机分成EEN组和肠外营养（TPN）组。自术后第2天起分别给予肠内和肠外营养支持治疗，观察并比较两组患者营养支持治疗前后血清营养指标及术后的消化道症状、肠功能恢复情况、术后感染性并发症的发生情况、营养药物费用、术后住院时间。结果两组患者的营养指标均较营养支持治疗前明显上升（均P〈0．05），而两组之间的差异无统计学意义（P〉0．05）；EEN组肛门恢复排气和排便时间较TPN组缩短（均P〈001），营养药物费用及术后住院时间亦少于TPN组（均P〈0．01），两组感染性并发症发生率的差异无统计学意义（P〉0．05）。结论腹部手术后进行EEN可显著改善患者的营养状况，促进肠功能恢复，并能节省医药费用。缩短术后住院时间。

Objective To evaluate the feasibility of early enteral nutrition （EEN） in postoperative patients of abdominal surgery. Methods Forty postoperative patients of abdominal surgery were randomized into EEN group（n=20） and total par- enteral I nutrition（TPN） group（n=20）. The nutritive index, the return of bowel function, the mean postoperative length of hospital stay and the mean cost of nutrition support were observed and compared between two groups. Results Levels of nutritive in- dex were significantly elevated after nutrition support in two groups（P〈0.05） and there was no significant difference between two groups（P 〉0.05）. Return of bowel function as measured by time to first passage of flatus and time to first defecation was significantly earlier in EEN group than those in TPN group（P〈0.01）. The mean postoperative hospital days and the mean cost of nutrition support in EEN group were significantly less than those in TPN group（P〈0.01）.There was no significant difference in incidence of septic complications between two groups（P 〉0.05）. Conclusion This study suggests that EEN can effectively improve nutritional condition in postoperative patients of abdominal surgery with earlier return of bowel function, less cost and shorter postoperative hospital days than those of TPN.