早期肠内营养与肠外营养在预防肝性脑病患者应激性溃疡出血和感染的疗效对比分析

Effects of early enteral nutrition and parenteral nutrition on prevention of stress ulcer bleeding and infections in patients with hepatic encephalopathy

目的比较早期肠内营养与肠外营养在预防肝性脑病患者应激性溃疡出血和感染的疗效,为此类患者营养支持方式的选择提供依据。方法选取2013年8月-2015年9月医院收治68例肝性脑病患者为研究对象,将其随机分为A组(肠外营养组)34例和B组(早期肠内营养组)34例,然后将两组患者应激性溃疡出血发生率、感染发生率、干预前及干预后不同时间的胃肠激素水平进行比较。结果 B组的应激性溃疡出血发生率为5.88%,明显低于A组17.65%,B组感染发生率为8.82%,明显低于A组23.53%,干预后不同时间的血清胃肠激素指标MTL及VIP均低于A组,而血清SS则高于A组,差异均有统计学意义P<0.05。结论早期肠内营养在预防肝性脑病患者应激性溃疡出血和感染的疗效明显好于肠外营养,因此本营养支持方式具有更高的应用价值。

OBJECTIVE To compare the effects of early enteral nutrition and parenteral nutrition on prevention of stress ulcer bleeding and infections in patients with hepatic encephalopathy so as to choose appropriate nutrition support approach for such group of patients .METHODS A total of 68 patients with hepatic encephalopathy who were treated in hospitals from Aug 2013 to Sep 2015 were recruited as the study objects and randomly divided into the group A with 34 cases （ the parenteral nutrition group） and the group B with 34 cases （ the early enteral nutri‐tion group） .The incidence of stress ulcer bleeding ,incidence of infection ,and levels of gastrointestinal hormones before and after intervention were observed and compared between the two groups of patients .RESULTS The inci‐dence of stress ulcer bleeding of the group B was 5 .88% ,significantly lower than 17 .65% of the group A ;the in‐cidence of infection of the group B was 8 .82% ,significantly lower than 23 .53% of the group A .Among the sero‐logical gastrointestinal hormone indicators ,the levels of MTL and VIP of the group B were lower than those of the group A ,however ,the level of serum SS of the group B was higher than that of the group A ,and there was sig‐nificant difference （P〈0 .05） .CONCLUSION The early enteral nutrition can achieve more significant effect than the parenteral nutrition on prevention of stress ulcer bleeding and infection in the patients with hepatic encephalop‐athy ,and it has higher application value .