全肠外营养在小儿肠穿孔治疗中的应用

Total parenteral nutrition in the treatment of bowel perforation in children

目的 探讨全肠外营养在治疗小儿肠穿孔中的作用。方法 对 48例肠穿孔患儿术后在综合治疗的基础上给予全肠外营养 (TPN)支持 ,TPN主要成分有 :葡萄糖、电解质、氨基酸、维生素混合液与脂肪乳剂 ,经周围静脉输入。另设对照组 36例肠穿孔患儿只给予综合治疗和部分静脉营养。结果 TPN组患儿全身情况改善 ,体重增加 32例 ,淋巴细胞数明显增加 40例。对照组体重增加 8例 ,淋巴细胞数量明显增加 16例。两组体重、淋巴细胞数增加经 χ2 检验 ,P <0 .0 0 1,差异具有显著性意义。TPN组治愈 41例 ,死亡 7例 ;对照组治愈 2 2例 ,死亡 14例 ,两组治疗结果经 χ2 检验 ,χ2 =12 .96 ,P <0 .0 0 1,两组相比差异具有显著性意义。证明TPN组疗效明显优于对照组。结论 本组TPN配方合理、方便、安全、有效 ,为肠穿孔术后患儿提供了足够的各种营养 。

Objective To discuss the effect of total parenteral nutrition (TPN) in the treatment of bowel perforation in children.Methods After operation for bowel perforation, 48 cases (experimental group) were given TPN on the basis of comprehensive treatment. The main ingredients of TPN were glucose, electrolytes, amino acids, vitamin and lipids. 36 controls were given comprehensive treatment plus partial peripheral nutrition.Results Patients in experimental group showed general improvement, with body weight increased in 32 subjects and the counts of lymphocytes increased in 40. While the in control group, The weight of 8 cases were increased and the count of lymphocytes were increased in 16 cases. There were significant differences in increase of body weight and lymphocytes as revealed by χ 2 , test ( P < 0.001 ). In the experimental group, 41 out of 48 cases were cured and 7 died, while in the control group, 22 out of 36 cases were cured, 14 died. The results of two groups were subjected to χ 2 test with χ 2= 12.96 and P < 0.001 , and the difference was significant. The result of experimental group was obviously better than that of the control group.Conclusions TPN is convenient, safe, and effective. It provides enough nutrition for the children who receive operation and has obvious effect.