肠内营养支持对胰十二指肠切除术后患者早期血糖控制及护理

Enteral nutrition supports early blood glucose control and nursing of patients after pancreaticoduodenectomy

目的探讨肠内营养支持对胰十二指肠切除术后患者早期血糖控制效果及护理。方法选取2014年7月~2017年7月在该院肝胆胰外科行胰十二指肠切除术的患者60例为研究对象。随机分为对照组和观察组,各30例。对照组采用肠外营养支持,观察组采用肠内营养支持。以术后血糖值、住院时间、肛门排气时间、恢复排便时间等为评价指标。结果术前两组患者血糖值比较,差异无统计学意义(P>0.05),术后两组血糖均呈先升高,后下降的趋势,差异有统计学意义(P<0.05),但术后1d、3d、7d观察组血糖值均显著低于对照组,差异有统计学意义(均P<0.05)。观察组住院时间、肛门排气时间、恢复排便时间、营养状况等手术相关指标均显著低于对照组,差异有统计学意义(均P<0.05)。观察组护理满意度显著高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。观察组出现1例胃排空延迟,对照组出现4例术后出血,1例胰瘘,1例胆瘘。结论肠内营养支持对胰十二指肠切除术患者早期血糖控制作用显著,可明显缩短住院时间,促进患者胃肠道功能恢复,改善患者营养状况,降低并发症发生率,提高护理满意度,值得临床推广应用。

Objective To investigate the effect of enteral nutrition support on early blood glucose control and nursing of patients after pancreaticoduodenectomy.Methods A total of 60 patients who underwent pancreaticoduodenectomy in hepatobiliary and pancreatic surgery department of the hospital from July 2014 to July 2017 were selected as the study objects and were randomly divided into control group and observation group,30 cases of each group. The control group received parenteral nutrition support,and the observation group received parenteral nutrition support. Postoperative blood glucose value,length of hospitalization,time of anal exhaust and time of recovery and defecation were taken as evaluation indexes.Results There was no significant difference in blood glucose between the two groups before operation(P>0.05). Postoperative blood glucose of the two groups showed a trend of increasing first and then decreasing,and the difference was statistically significant(P<0.05). However,1 day,3 days and 7 days after surgery,the blood glucose values of the observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05). The hospitalization time,anus exhaust time,recovery defecation time,nutritional status and other surgical indicators in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05). Nursing satisfaction in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05). In the observation group,there was 1 case of delayed gastric emptying,4 cases of postoperative bleeding,1 case of pancreatic fistula and 1 case of biliary fistula in the control group.Conclusions The effect of enteral nutrition support on early blood glucose control in patients with pancreaticoduodenectomy is significant,which can significantly shorten the hospitalization time,promote the recovery of gastrointestinal function,improve the nutritional status of patients,reduce the incidence of complications,and improve nursing satisfaction,which is worthy of clinical promotion and application.