肝内胆管结石行肝叶切除术患者围手术期营养支持

Perioperative nutritional support for patients with intrahepatic bile duct stones undergoing hepatectomy

目的探讨肝内胆管结石行肝叶切除术患者同手术期的肠内外营养支持对手术治疗效果的影响。方法回颐性分析2011年3月一2015年3月重庆市涪陵中心医院收治的55例肝叶切除术患者，均为择期手术。根据围手术期营养支持方法的不同，随机分为肠内外营养组（n=25）和肠外营养组（n=30）。结果肠内外营养组术后并发症发病率及肠道功能恢复时间，明显优于肠外营养组（28％VS40％），[（4．50±0．50）d vs（5．50±1．00）d]，差异有统计学意义（P〈0．05）；两组手术前后体重指数变化[（22．10±1．80）vs（22．30±1．70）]、前白蛋白[（130．00±45．00）mg／Lvs（124．00±55．00）mg／L]和白蛋白[（35．50±2．72）g／L vs（36．50±2．70）g／L]改善情况，差异无统计学意义（P〉0．05）。结论围手术期肠内外营养支持可明显改善患者的营养状况，缩短术后肠道功能恢复时间及住院日，提高手术治疗效果。

Objective To Discuss the effect of surgical treatment from enteral and parenteral nutrition that in perioperative period of hepatolithiasis patients who taking hepatectom. Methods Retrospective analysis 55 cases who taking hepatectomy treatment in Fuling Central Hospital of Chongqing City from March 2011 to March 2015, all elective operations. According to the different nutrition support methods in perioperative period, randomly divided into enteral and parenteral group （n = 25 ） and pareuteral nutrition group （n = 30）. Results The postoperative complication rate and recovery time of bowel function in patients with enteral and parenteral nutrition, it was betterthan parenteral nutrition group（28% vs 40% ）, [ （4.50 ±0.50） d vs （5.50 ±1.00） d], the difference had statis- tical significance （P 〈0.05）. Before and after operation in two groups of body mass index [ （22. 10 ± 1.80） vs （22.30 ± 1.70） ], prealbunfin impovement [ （ 130.00 ±45.00） mg/L vs （ 124.00± 55.00） mg/L ], albumin impovement [ （35. 50 ± 2. 72） g/L vs （36. 50 ± 2.70） g/Ll, had no statistical significance （P 〉 0. 05 ）. Conclusion Enteral and parenteral nutrition in perioperative can significantly improve the nutritional status of pa- tients and the effect of surgical treatment.