静脉镇痛联合早期营养支持对原发性肝癌患者术后肝功能的影响

Effect of Patient-controlled Intravenous Analgesia Combined Nutrition Support on Postoperative Rehabilitation of Liver Function in Patients Receiving Hepatectomy

目的探讨静脉镇痛联合早期营养支持对原发性肝癌患者术后肝功能的影响。方法 2013年6月—2014年2月选择入我院手术治疗的原发性肝癌患者200例,按随机数字表法分为观察组和对照组各100例。对照组给予常规护理,即术后患者主诉疼痛时给予止痛药物治疗,持续胃肠减压待肛门排气后拔除胃管再进食。观察组患者术后48 h内采取持续静脉镇痛,并给予早期肠外和肠内营养支持。观察比较术后第4天2组患者血清白蛋白、谷丙转氨酶及谷草转氨酶的情况。结果术后第4天观察组血清白蛋白高于对照组(P<0.05),谷丙转氨酶、谷草转氨酶均低于对照组(P<0.05)。结论静脉镇痛联合早期营养支持,既能减轻术后患者的疼痛,同时早期营养支持又能促进肝蛋白质合成,有效促进原发性肝癌患者术后肝功能的恢复。

Objective To explore the effects of the combination of patient-controlled intravenous analgesia and enteral and parenteral nutrition support on patients with primary liver cancer after hepatectomy. Methods A total of 200 patients who met the inclusion criteria were randomly divided into observation group（n=100）and control group（n=100）. In control group, patients received routine treatment and nursing. Pain treatment was provided when patients complained of pain. The patients received continuous gastrointestinal decompression and after the removing of stomach tube, patients resumed oral intake after gastrointestinal function recovered. In observation group, patients received the combination of nutrition support therapy and patient-controlled intravenous analgesia within 48 hours after the postoperative patients were awake. The parameters that included albumin（ALB）, alanine aminotransferase（ALT） and aspartate aminotransferase（AST） on postoperative day（POD） 4 between two groups were compared.Results The level of ALB in observation group was significantly higher than that of control group（ P〈0.05） and the levels of ALT and AST in observation group were significantly lower when compared with those of control group（ P〈0.05）. Conclusion Patientcontrolled intravenous analgesia combined early nutrition support can effectively reduce postoperative pain, promote liver protein synthesis and accelerate postoperative rehabilitation of liver function for the patients receiving hepatectomy.