短肽型肠内营养制剂对脊柱术后患者早期营养支持的耐受性及效果观察

Effects of peptide-based enteral products on tolerance and outcome in spinal surgery patients during early nutritional support

目的探讨脊柱术后患者对两种肠内营养制剂的耐受性,观察肠道功能恢复情况,评价营养支持效果。方法选取2015年3-5月第三军医大学新桥医院骨科脊柱术后患者100例,分为研究组50例,对照组50例。研究组给予短肽型肠内营养制剂支持,对照组给予整蛋白型肠内营养制剂支持,比较两组患者血清总蛋白、白蛋白、前白蛋白、术后首次肛门排气时间、术后24 h内肠鸣音情况及术后24 h内腹胀、腹泻、恶心、呕吐发生率。结果与对照组比较,研究组首次肛门排气时间显著缩短[(14.4±5.1)vs(16.8±5.0)h,P=0.021];研究组腹胀发生率、恶心发生率显著低于对照组(4%vs18%,P=0.025;6%vs 24%,P=0.012);营养支持前、后,患者血清总蛋白、白蛋白、前白蛋白研究组与对照组比较差异无统计学意义(P>0.05)。结论短肽型肠内营养制剂能显著缩短脊柱术后患者胃肠道恢复时间并提高患者胃肠道耐受性。

Objective To observe the tolerance of 2 kinds of enteral products and recovery of gastrointestinal function in postoperative spine patients, and evaluate the effect of the early nutritional support. Methods A total of 100 postoperative patients in the orthopedic department of our hospital from March to May 2015 were enrolled in this study. They were divided into the study group （n=50, given the peptide-based enteral products） and the the control group （n=50, given the whole protein enteral products）. The serum contents of total proteins, albumin and pre-albumin, first flatus time after surgery, and bowel sounds and incidences of bloating, diarrhea, nausea and vomiting within 24 h postoperatively were measured and recorded, and the results were compared between the 2 groups. Results The first flatus time after surgery was significantly shorter in the study group than the control （14.4±5.1 vs 16.8±5.0 h, P=0.021）. The study group also had obviously lower incidences of bloating and nausea when compared with the control （4% vs 18%, P=0.025; 6% vs 24%, P=0.012）. No significant differences were seen in the serum contents of total proteins, albumin and prealbumin between the 2 groups after nutrition support （P〉0.05）. Conclusion The peptide-based enteral products significantly shorten the recovery time of gastrointestinal function and increase gastrointestinal tolerance in the patients after spinal operation.