肠外营养支持对胃肠道疾病手术患者临床结局的影响

The Impact of Parenteral Nutrition on Clinical Outcome in the Surgical Patients with Gastrointestinal Diseases

目的调查吉林省5家中小医院普外科胃肠道疾病手术患者由于营养风险而引起的术后并发症的特点及住院时间等,观察营养支持对普外科胃肠道疾病手术患者临床结局的影响。方法在本项队列研究中,收集了吉林省长春地区、松原地区、白城地区等5家中小医院2010年5月至2013年3月普外科住院患者4349例,排除年龄<18或>80岁、住院时间不足24h或次日8时前手术、神志不清、拒绝参加本研究、不符合预定诊断的、符合预定诊断且未手术的病例后405例的住院患者的资料,资料主要包括营养风险筛查、肠内肠外营养应用情况、手术名称、并发症、住院时间。结果上述地区共收集符合纳入标准患者405例,存在营养风险的患者为170例,无营养风险的患者为235例,总并发症26例,有营养风险患者接受肠外营养支持后并发症发生率4.9%,未接受肠外营养支持的患者并发症发生率14.7%;平均住院时间13d。结论营养支持可减少有营养风险患者并发症的发生。无营养风险应用营养支持不能减少并发症的发生和缩短住院时间。

Objective To investigate the features of postoperative complication and length of hospital stay caused by nutritional risk on surgical inpatients with gastrointestinal diseases in general surgery department of 5 middle and small hospitals in Jilin province.Observe the impact of parenteral nutrition on clinical outcome in the surgical patients with gastrointestinal diseases. Methods In the cohort study, a total of 4349 hospitalized patients from 5 hospitals of relatively developed Changchun area, Songyu area, and Baicheng area in general surgery department of Jilin province were recruited from May 2010 to March 2013. Aider the patients were excluded for hospital lengh of age less than 18 years old or more than 80 years old, stay less than 24 hours or operation before the next day 8 o＇clock, obnubiation and/or refuse to participate in the research, and inconformity to scheduled diagnosis, 405 cases were sampled. Collected research material mainly included nutrition risk screening, the status of application on enteral and paraenteral nutritional support, operation, complications and length of hospital stay. Results A total of 405 eases met the inclusion criteria were recruited from these areas. There are 235 eases at non- nutritional-risk, and there are 26 at complications.The incidence of complication was 4.9% in at-nutritional risk patients recieved enteral nutritional support and 14.7% in at-nutritional risk patients non-enteral nutritional support. Conclusion Nutrition support can decrease compliactions of at-nutritional-risk patients and length of hospital stay, but non-nutritional-risk patients is not so.