消化液回输治疗小肠中断病人的疗效分析

Effect of digestive juice reinfusion in patients with small intestine interruption

目的:回顾性分析消化液回输在小肠中断病人中的治疗效果。方法:收集空军军医大学西京医院消化外科2015年7月至2017年7月使用消化液回输泵治疗肠道连续性中断的30例病人病例资料,比较回输前与回输后4周血清白蛋白(ALB)、外周血总淋巴细胞计数(TLC)、预后营养指数[PNI=淋巴细胞绝对值(10~9/L)×5+血清白蛋白(g/L)]、体质指数(BMI)等营养指标以及回输前与回输后10天消化液丢失量、静脉液体量和经口进食量等指标。结果:回输4周后,ALB为[(32.9±4.7)vs(38.9±3.8)]g/L,P <0.001;TLC为[(1.3±0.3)vs(1.8±0.4)]×10~9/L,P <0.05;PNI为[(39.5±5.1) vs (47.9±4.7)],P <0.001;BMI为[(21.4±3.5)vs(22.1±2.9)]kg/m^2,P <0.05。回输10 d后,消化液丢失量[(1 374.7±837.4)vs (0)]mL/d,P <0.001;静脉液体量[(1 641.1±677.5) vs (1 151.7±553.5)] mL/d, P <0.05;经口进食量[(297.6±385.1)vs (610.6±381.4)]mL/d, P <0.001。肠内营养达到目标量平均时间(13.60±6.06)d,肠内营养平均用量(1 005.45±533.84)mL/d。营养指标ALB、PNI、TLC、BMI均显著升高;消化液丢失量、静脉液体量显著减少,经口进食量增加。结论:消化液回输泵回输消化液能显著改善肠道连续性中断病人营养状况,促进肠道吸收功能恢复,减少消化液丢失量和静脉输液量,增加经口进食量。

Objective: Retrospective analysis of the effect of digestive juice reinfusion in patients with small intestine interruption. Methods: Thirty patients of discontinuous of intestinal tract which all used chyme reinfusion pump from July 2015 to July 2017 Digestive Hospital of Xijing Hospital of Air Force Military Medical University were enrolled in the study.Serum albumin(ALB), peripheral blood total lymphocyte count(TLC), prognosis nutritional index [PNI=absolute value of lymphocyte(10~9/L) ×5 + serum albumin(g/L)] and body mass index(BMI) before and after 4 weeks of chyme reinfusion were determined. Loss of digestive juice, venous fluid volume and oral intake before and after 10 days of chyme reinfusion were calculated. Results: As compared to pre-reinfusion, ALB[(32.9 ± 4.7)vs(38.9 ±3.8)] g/L, P < 0.001; TLC([1.3 ± 0.3)vs(1.8 ± 0.4)] ×10~9/L, P < 0.05; PNI [(39.5 ± 5.1) vs(47.9 ± 4.7)], P < 0.001; BMI[(21.4 ± 3.5)vs(22.1 ± 2.9)] kg/m^2, P < 0.05. After 10 days compared to pre-reinfusion, loss of digestive juice [(1374.7 ± 837.4)vs(0)] mL/d, P < 0.001; Venous fluid volume [(1 641.1 ± 677.5) vs(1 151.7 ± 553.5)] mL/d, P < 0.05]; Oral intake [(297.6 ± 385.1)vs(610.6 ± 381.4)] mL/d, P < 0.001, The average time of enteral nutrition to reach the target is(13.60 ± 6.06)d; Average amount of enteral nutrition is(1005.45 ± 533.84)mL/d. Nutritional indexes of ALB, PNI, TLC and BMI all increased. Loss of digestive juice and venous fluid volume dramatically reduce, Oral intake significantly increased. Conclusions: Digestive juice reinfusion can apparently improve the nutritional status and intestinal absorption function of patients with small intestine interruption because of reduce of loss of digestive juice and venous fluid volume and increase of oral intake.