早期肠内营养支持对高龄重症心脏瓣膜病患者术后康复的影响

Effect of early enteral nutrition support on postoperative rehabilitation in elderly patients with severe heart valve disease

目的观察早期肠内营养支持对高龄重症心脏瓣膜病(HVD)患者术后康复的影响。方法将90例高龄重症HVD患者按随机数表法分为两组,A组(45例)接受常规肠内营养支持,B组(45例)接受早期肠内营养支持。对比两组患者入住ICU病房当天以及营养支持7 d后营养指标及免疫功能、住院时间及术后并发症发生率。结果营养支持治疗7 d后,两组患者Hb、PA、ALB水平均高于入住ICU病房当天,且B组患者Hb、PA、ALB水平均高于A组,差异有统计学意义(P <0. 05)。营养支持治疗7 d后,两组患者Ig A、Ig G、Ig M水平均高于入住ICU病房当天,且B组患者Ig A、Ig G、Ig M水平均高于A组,差异有统计学意义(P <0. 05)。A组患者住院时间为(11. 42±1. 63) d,B组患者住院时间为(9. 16±1. 55) d。B组患者住院时间短于A组,差异有统计学意义(P <0. 05)。B组患者切口感染、腹泻、呕吐发生率均低于A组,差异有统计学意义(P <0. 05)。结论早期EN治疗高龄重症HVD临床效果较好,可有效改善其免疫功能,有推广价值。

Objective To observe the effect of early enteral nutrition support on postoperative rehabilitation of elderly patients with severe heart valve disease(HVD).MethodsNinety elderly patients with severe HVD were randomly divided into two groups.Group A(43 cases)received conventional enteral nutrition support and group B(47 cases)received early enteral nutrition support.Nutrition index,immune function,hospitalization time and postoperative complication rate were compared between the two groups on the day of admission to ICU and 7 days after nutritional support.ResultsThe levels of Hb,PA,ALB 7 days after nutritional support in two groups were higher than those on the day of admission to ICU,and the levels of Hb,PA,ALB in group B were higher than group A(P<0.05).The levels of IgA,IgG,IgM 7 days after nutritional support in two groups were higher than those on the day of admission to ICU,and the levels of IgA,IgG,IgM in group B were higher than group A(P<0.05).The hospitalization time of patients in group A was(11.42±1.63)days,and that was(9.16±1.55)days in group B.The hospitalization time of patients in group B was shorter than that in group A(P<0.05).The incidence rates of incision infection,diarrhea and vomiting in group B were lower than those in group A(P<0.05).ConclusionEarly EN treatment has a better clinical efficacy for elderly patients,can effectively improve immune function,has the value of promotion.