腹部外科患者的个体化肠外与肠内治疗

Individual parenteral and enteral therapy of abdominal surgical patients

目的:探讨腹部外科术后患者营养治疗方法。方法:经营养风险筛查(NRS2002)筛查出有营养风险腹部手术的患者48例,随机分为两组,每组24例。治疗组为EN+PN+治疗膳食,对照组为PN+治疗膳食。对比观察营养治疗后两组患者的血红蛋白(Hb)、血清清蛋白(ALB)、外周血淋巴细胞总数(LC),三头肌皮褶厚度(TSF)等营养指标以及血浆IgG、IgM和IgA免疫指标。结果:治疗后14 d,治疗组ALB、Hb、LC和TSF值均高于对照组,ALB显著高于对照组(P<0.05);IgG、IgA治疗组恢复较快并超过术前水平,显著高于对照组(P<0.05)。结论:合理地选择营养治疗方式,及时地调整EN、PN的比例,使营养治疗更加合理,能促进患者术后更好的康复。

Objective To study the nutritional therapy on patients after abdominal surgery.Method The NRS2002 screening of nutritional risk in 48 patients with abdominal operation,were randomly divided into two groups,24 cases in each group,the treatment group had EN ＋ PN ＋ therapeutic diet,control group had PN ＋ therapeutic diet.Observed comparatively the nutritional therapy in two patients with hemoglobin（Hb）,serum albumin（ALB）,peripheral blood lymphocyte count（L.C）,triceps skinfold（TSF） and other nutritional indexes as well as the plasma levels of IgG,IgM and IgA immune indexes.Results 14 days after treatment,ALB,Hb,L.C and TSF values of treatment group were higher than those of control group,ALB was significantly higher than that of control group（P 0.05）,IgG,IgA treatment group recovered quickly and exceeded the level before surgery,significantly higher than those in control group（P 0.05）.Conclusion Reasonable choice of nutritional treatment,timely adjustment of EN,PN ratio can make the nutrition treatment more reasonably,can promote the rehabilitation of postoperative patients.