老年人大肠癌术后6小时肠内营养的应用

CLINICAL STUDY ON ENTERAL NUTRITION SUPPORT FOR ELDERLY BEGUN AT SIX HOURS AFTER OPEN RECTUM COLON RESECTION

目的 客观评价老年人大肠癌术后早期肠内营养支持的安全性和有效性以及对机体的影响。方法应用含纤维素的肠内营养制剂（能全力），通过鼻肠管和肠内营养输液泵，在术后６小时即开始给予患者肠内营养支持，观察临床和测定营养支持前后患者的血糖、肝肾功能和电解质以及营养指标。结果 肠内组病人应用能全力后肛门排气恢复时间５９．６±８．１小时，比较对照组７４．９±２６．１小时快，Ｐ＜０．０１。所有病人没出现腹泻和感染性并发症。１２例病人均能耐受术后６小时开始的肠内营养。血糖、肝肾功能和电解质在二组间没有变化。肠内组病人应用能全力后体重比较对照组上升，但仍在正常范围。肠内组病人应用能全力后转铁蛋白比较对照组上升，Ｐ＜０．０５。肠内组病人应用能全力后纤维连接蛋白比较对照组明显上升，Ｐ＜０．０１。结论 积极地开展老年人术后早期肠内营养（含纤维系）是安全有效的，它对于促进胃肠功能恢复，保持肠道粘膜屏障，防治感染性并发症，改善机体营养状况起到了一定的积极作用。

Objective To evaluate the safety and effect of enteral nutrition support at early period after open rectum colon resection in elderlys .Methods 21 patients were divided postoperatively into two groups. The enteral nutriting group (EN group, n = 12) received nutrition fibre enterally for 7 days, and the control group (n = 9) received intravenous isotonic glucose solution and oral liquid diet after the bowel movement recovery, The blood glucose, function of liver and kidney, electrolytes, and nutritional status were observed. The recovery of bowel movement and other digestive symptems such as abdominal pain, distention, diarrhea, nausea and vomiting were observed during the period of study .Results The recovery of bowel movement in EN group is much earlier than that in the conreol group. Transferrin (Tf) and Fibrous binding Protein (FN) in the EN group were increased significantly (P < 0 .05 and P < 0. 01 ). No other significant changes were noted in both coups. Conclusions This method of entral nutrihon support is safe and effective formaintaining enteral protective screen and improving the gastroenteric function and nutrition condition of patients.