儿童胰腺肿瘤术后早期肠内营养支持治疗分析

Analysis of early enteral nutrition support in pediatric patients with pancreatic tumor

目的探讨早期肠内营养支持治疗在儿童胰腺肿瘤术后的应用价值及安全性。方法回顾性收集肿瘤外科收治的胰腺肿瘤患儿15例为早期肠内营养(EN)组,配对收集早期肠外营养(PN)组病人15例,监测两组患者胃肠道耐受情况、营养指标、并发症发生情况、体质量变化、住院时长、住院费用等变化。结果两组患者年龄范围、术前体质量、术前营养指标比较均无显著性(P>0.05)。早期EN组术后第7d淋巴细胞计数、血尿素氮水平、血肌酐水平,术后第14d红细胞计数、血红蛋白浓度、淋巴细胞计数、血肌酐水平以及早期PN组术后第7d和术后14d红细胞计数、血红蛋白浓度、淋巴细胞计数均较术前下降,差异有显著性(t=2.26~5.63,P<0.05)。早期EN组术后第14d血红蛋白、淋巴细胞计数、血清白蛋白、前白蛋白,第7d血肌酐水平均高于早期PN组,差异有显著性(t=2.23~3.41,P<0.05)。两组患者不良反应存在差异,但差异无显著性(P>0.05)。结论儿童胰腺肿瘤术后早期肠内营养支持与肠外营养支持的并发症发生率无显著差异,但早期肠内组在改善机体的营养指标、减少体重丢失、缩短住院时长、减轻住院费用方面更有优势。

Objective To explore the value and safety of the application of early enteral nutrition in pediatric patients with pancreatic tumor.Methods Retrospectively analyzed and compared the nutritional status,complication,body weight change,hospitalization duration and expenses of the patients after surgical intervention by the early enteral nutritional group(EN group,15 cases)and the early parenteral nutritional group(PN group,15 cases).Results There was no statistically significant difference between 2 groups on age,preoperative body weight,preoperative nutritional indicators(P>0.05).In EN group,the lymphocyte,blood urea nitrogen,serum creatinine in post-operation day 7,and the red blood cell,hemoglobin,lymphocyte,serum creatinine in post-operation day 14.In PN group,the red blood cell,hemoglobin,lymphocyte in post-operation day 7 and day 14.There are all significantly decreased than preoperational levels(t=2.26~5.63,P<0.05).In EN group,the hemoglobin,lymphocyte,albumin,prealbumin in day 14 and the serum creatinine in day 7 are significantly increased than PN group(t=2.23~3.41,P<0.05).The patients were suffered from different complications in 2 groups,but there was no statistical differences among them(P>0.05).Conclusions Enteral nutritional support could not decrease the incidence of post-operation complications in children with pancreatic tumor,while it may improve the nutritional status,reduce the body weight lost,shorten the hospital stay and reduce the cost in comparison with parenteral nutrition.