胰十二指肠切除术后肠内外联合营养支持的临床疗效观察

Clinical observation of joint enteral and parenteral nutritional support after pancreatoduodenectomy

目的探讨胰十二指肠切除术后患者肠内外联合营养支持方式的临床疗效。方法选取我院2005年12月至2008年6月行胰十二指肠切除术后应用肠内营养联合肠外营养支持方式的患者65例,观察术后第1天、第7天、第14天、第21天血清总蛋白、白蛋白、总淋巴细胞计数等各项营养指标的变化及术后并发症发生率。结果术后第7天、第14天、第21天的血清总蛋白、白蛋白水平及外周血淋巴细胞总数均较术后第1天明显增高(P<0.05),其中总蛋白和白蛋白随时间推移呈递增趋势。绝大多数患者对肠内营养耐受性良好。术后1例出现胃瀦留,5例出现发热,1例出现高血糖,2例出现腹泻、排便次数增多,1例出现恶心、呕吐。结论肠内外联合营养支持方式总体疗效令人满意,胰十二指肠切除术后早期采用肠内营养是安全的,可依据术后患者的具体情况,合理早期应用肠内营养。

Objective To observe the clinical effect of enteral nutrition combined with parenteral nutrition after pan- creaticoduodenectomy. Methods The 65 patients who underwent panereaticoduodenectomy were chosen from Dec, 2005 to Jun,2008. After the surgery they received EN and PN. The levels of total serum protein and albumin, and the counts total lymphocytes were measured on preoperative day and the 1st, 7th, 14th and 21st postoperative days. The complications were also observed. Results The levels of total serum protein and albumin, and the counts total lymphocytes on the 7th, 14th and 21st operative compared those on the 1st postoperative day, the nutrition indexes The complications relating to Enteral nutrition included 1 case of gastric retention, 5 cases of [ever, 1 case of hyper- glycemia, 2 cases of ascites and 1 case of nausea. Conclusion EN-{-PN is safe and satisfied as the main nutrition sup- port after pancreatic^-duodenectomy. Enteral nutrition should be used in the beginning of postoperation based on the status of the patients.