胰腺、十二指肠、肾一期联合移植围手术期的营养管理

Perioperative nutritional management of pancreaticoduodenal and kidney transplantation patients

目的 :总结胰肾联合移植围手术期的营养管理 ,提高器官移植的成功率 ,减少术后并发症 ,促进康复。 方法 :行胰腺、十二指肠和肾一期联合移植 5例。术前肠内营养支持的原则为高热量、高蛋白、高维生素 ,同时加大胰岛素用量 ,以便增加营养 ,尽快改善全身营养状况 ,为手术作好准备。术后分阶段给予全静脉营养、肠内营养加静脉营养 ,直至完全停用静脉营养。 结果 :2例病人体重、上臂围、肱三头肌皮褶厚度较入院时增加 ,4例血清白蛋白、血红蛋白增加 ,3例血清总蛋白增加。 结论 :胰肾联合移植围手术期营养管理十分必要 ,分阶段的营养支持是可行的。提供合适的热量和营养物质是围手术期营养支持成功与否的关键 ,营养状况的改善与病情及营养支持时间长短有关。

Objectives:To summarize the experience of nutrition management in pancreaticorenal transplantation patients. Methods:The principle of enteral nutrition before operation is high energy,rich protein and vitamin,and increased insulin usage,in order to ameliorate malnutrition for operation.Intravenous nutrition, intravenous nutrition plus enteral nutrition, and enteral nutrition were applied respectively during the postoperative stage. Results:The body weight,circumference of upper arm and skin fold thickness of triceps muscle increased in two patients,plasma albumin and hemoglobin increased in four,and total plasma protein increased in three. Conclusions:Nutrition management of the patients is very necessary for pancreaticorenal transplantation patients,and the stepwise nutrition support after operation is feasible.Appropriate calories and nutritional elements are essential to the nutrition support,and the nutritional amelioration correlates with the condition and period of nutrition support.