胰十二指肠切除术后肠内外联合营养与完全胃肠外营养的临床疗效比较

Clinical efficacy of enteral nutrition combined with parenteral nutrition versus total parenteral nutrition in patients after pancreaticoduodenectomy

目的:比较临床中胰十二指肠切除术后应用肠内外联合营养与完全胃肠外营养的临床疗效.方法:选取2013-01/2013-12于我院行胰十二指肠切除术的手术患者80例为研究对象,将其按照随机数字法分为A组和B组,各40例.A组患者给予肠内外联合营养支持,B组患者给予完全胃肠外营养支持,观察两组的应用效果.结果:治疗前,A组和B组患者的白细胞计数、血清白蛋白和转铁蛋白比较差异无统计学意义(P>0.05);治疗后,A组和B组患者的白细胞计数、血清白蛋白和转铁蛋白较治疗前有明显的改善,但是治疗后组间数据比较无统计学意义(P>0.05);A组患者住院时间和治疗费用均明显的低于B组患者,比较差异无统计学意义(33.41 d±11.82 d vs 39.73 d±13.72 d6.36万元±1.21万元vs 8.93万元±2.14万元P<0.05);两组患者术后并发症发生率比较差异无统计学意义(12.5%vs 15.0%,P>0.05).治疗前,两组患者的体质量比较差异无统计学意义(P>0.05);治疗后,A组患者体质量明显高于B组,差异有统计学意义(P<0.05).A组患者肠蠕动恢复时间和排气、排便时间均明显改善差异有统计学意义(P<0.05).结论:临床中对于胰十二指肠切除术患者术后应用肠内外联合营养与完全胃肠外营养具有较好的应用效果,但是肠内外联合营养支持治疗费用低,且不增加术后并发症的风险,值得临床中应用.

AIM： To compare the clinical efficacy of enteral nutrition combined with parenteral nutrition versus total parenteral nutrition in patients after pancreaticoduodenectomy. METHODS： Eighty patients who underwent pancreaticoduodenectomy from January 2013 to December 2013 at our hospital were randomly and equally divided into two groups： A and B. Group A was given enteral nutrition combined with parenteral nutrition postoperatively, while group B was given total parenteral nutrition. The clinical effects were compared between the two groups. RESULTS： Before treatment, patients betweenthe two groups had comparable white blood cell count, serum albumin and transferrin （P 〉 0.05 for all）. After treatment, white blood cell count, serum albumin and transferrin were significantly improved in both groups, but there were no significant differences between the two groups （P 〉 0.05 for all）. The hospital stay and treatment costs were significantly lower in group A than in group B [33.41 d ± 11.82 d vs 39.73 d ± 13.72 d, （6.36 ± 1.21） ten thousand Yuan vs （8.93±2.14） ten thousand Yuan, P 〈 0.05 for both]. There was no significant difference in the rate of postoperative complications （12.5% vs 15.0%, P 〉 0.05）. Before treatment, the two groups showed no significant difference in body weight （P 〉 0.05）. After treatment, body weight increased significantly in group A （P 〈 0.05）. The times to recovery of bowel sounds, exhaust and defecation were sig- nificantly better in group A than in group B （P 〈 0.05 for all）. CONCLUSION： Both enteral nutrition combined with parenteral nutrition and total parenteral nutrition have good clinical efficacy in patients after pancreaticoduodenectomy, with the former having lower costs without increasing the risk of postoperative complications.