早期肠内营养在上消化道溃疡穿孔治疗中的临床价值

Clinical value of early enteral nutrition in the treatment of upper gas-trointestinal tract ulcer perforation

目的观察上消化道溃疡穿孔早期行肠内营养的临床疗效。方法回顾性分析我院2013年1月～2015年1月收治的上消化道溃疡穿孔患者60例,入院时符合标准的被随机分为对照组和实验组,各30例,对照组在手术时将普通胃管置于胃腔内,术后在常规治疗基础上给予全胃肠外营养治疗,实验组在手术时将空肠营养管置于Treitz韧带以下10 cm空肠内,术后在常规治疗基础上给予早期肠内营养治疗,比较两组治疗后的疗效。结果两组治疗1周后,血清总蛋白（TP）、白蛋白（ALB）和血红蛋白（Hb）等营养指标较治疗前有明显升高,且实验组白蛋白和血红蛋白指标改善程度均显著优于对照组（P〈0.05）;实验组肛门排气时间早于对照组,平均住院时间短于对照组,平均住院费用低于对照组,术后总的并发症发生率低于对照组（P〈0.05）。结论上消化道溃疡穿孔早期行肠内营养可有效改善患者的营养状况,并发症少,恢复快,住院时间短,并且节省费用,值得临床上推广应用。

Objective To investigate the clinical value of early enteral nutrition in the treatment of upper gastrointestinal tract ulcer perfor ation.Methods Sixty cases diagnosed as upper gastrointestinal tract ulcer perforation in our hospital from January 2013 to January 2015 were retrospectively analyzed and randomly divided into control group and experimental group,each of 30 cases,the control group at the time of surgery was normal gastric tube in the stomach cavity,was treated with postoperative total parenteral nutrition therapy on the basis of routine therapy,the experimental group in puts jejunum nutrition tube Treitz ligament surgery the following 10 cm in the jejunum,after operation,treated with early postoperative enteral nutrition therapy on the basis of conventional treatment.The efficacy was compared between the two groups.Results After opration for 1 week,the TP,ALB,Hb nutrition indicators were all significantly higher than before treatment,the experimental group of ALB and Hb nutrition indicators were significantly better than the control group（P〈0.05）;the postoperative exhaust time and the average hospitalization time were significantly shorter than the control group;the average hospitalization costs were less than the control group;and the total incidence of postoperative complications were significantly lower than the control group（P〈0.05）.Conclusion Early enteral nutrition therapy after upper gastrointestinal tract ulcer perforation operation is able to effectively improve the nutritional status of patients,reduce postoperative complications,promotes the rehabilitation of patients,and reduce hospitalization costs.It is worthy of clinical promotion.