经鼻肠管胆汁回输联合肠内营养治疗恶性胆道梗阻的效果

The Value of External Biliary Recycle Combined with Enternal Nutrinal through Nasointestinal Feeding Tube on Treatment of the Malignant Obstructive Jaundice

目的探讨经鼻肠管途径外引流胆汁回输联合肠内营养治疗恶性胆道梗阻的价值。方法 59例行减黄术的恶性胆道梗阻患者,术后接受7d相同热量的肠外营养(PN)和肠内营养(EN),根据胆汁引流和营养支持方式的不同分为观察组(经鼻肠管外引流胆汁回输+EN组,n=25例)和对照组(胆汁内引流+PN组,n=34例),对比分析治疗前后两组体质指数(BMI)、总胆红素(TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、白蛋白(ALB)、血清前清蛋白(PA)、免疫球蛋白Ig G、Ig A、Ig M变化。结果 1周后与对照组比较,观察组肝功能指标TBIL、AST、ALT显著下降(P<0.05),营养指标ALB、PA显著上升(P<0.05),免疫学指标Ig A、Ig G、Ig M显著上升(P<0.05)。结论经鼻肠管途径胆汁回输联合肠内营养治疗恶性胆道梗阻安全、廉价,有利于改善患者的营养状况,促进肝功能恢复和提高免疫力。

Objective To evaluate the value of external biliary recycle combined with enternal nutrition through nasointestinal feeding tube on treatment of the malignant obstructive jaundice. Methods Fifty- nine patients with the malignant obstructive jaundice received seven- day enternal nutrition（ EN） or parenteral nutrition（ PN） after alleviative biliary drainage. All the cases were divided into observation group（ external biliary recycle combined with EN group,n = 25 cases） and control group（ biliary enternal drainage combined with PN group,n = 34 cases）. The changes of liver function,nutrition and immunity were observed. Results Compared with the control group,in the observation group,nutritional index of patients were improved（ P〈0. 05）,the levels of liverenzyms,bilirubin were decreased obviously（ P〈0. 05） humoraland cellular immunity indicators were improved（ P〈0. 05）. Conclusion External biliary recycle combined with enternal nutrition through nasointestinal feeding tube has the significent clinical value which is safe and inexpensive. It can improve the nutritional condition of the patient suffering from malignant obstructive jaundice,promote rite restore of the hepatic function,increase the immune activity.