早期肠内营养支持对先天性心脏病患儿术后恢复的影响

Application value of early enteral nutrition support in postoperatiive recovery of children patients with congenital heart disease

目的观察早期肠内营养支持对先天性心脏病(CHD)患儿术后恢复的影响。方法将90例CHD患儿随机分为对照组和观察组,每组45例;对照组围手术期予以常规营养支持,观察组予以早期肠内营养支持。比较两组手术前后血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、视黄醛结合蛋白(RBP)、前白蛋白(Pre-ALB)水平及年龄别体重Z评分(WAZ)变化,并记录患儿首次排便时间、呼吸机置管时间、ICU入住时间及术后住院时间。结果观察组术后血清CRP、TNF-α、IL-6均明显低于对照组(P<0.05),RBP、Pre-ALB及WAZ水平明显高于对照组(P<0.05)。观察组较对照组首次排便时间明显提前(P<0.05),两组呼吸机置管时间、ICU入住时间、术后住院时间比较无统计学差异(P>0.05)。结论早期肠内营养支持能够促进CHD患儿术后胃肠动力恢复,改善营养状况。

Objective To observe the effect of early enteral nutrition support on postoperative recovery of children patients with congenital heart disease(CHD).Methods 90 children patients with CHD were randomly divided into control group and observation group,45 cases in each group.Control group was given routine nutritional support during perioperative period and the observation group was given early enteral nutrition support.The levels of serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),retinal binding protein(RBP),prealbumin(Pre-ALB)and weight-for-age Z-score(WAZ)were compared between the two groups before and after operation.The first defecation time,ventilator catheterization time,ICU stay time and postoperative hospitalization time were recorded.Results The levels of serum CRP,TNF-αand IL-6 in observation group after operation were significantly lower than those in the control group(P<0.05),while the levels of RBP,Pre-ALB and WAZ were significantly higher than those in control group(P<0.05).The first defecation time in observation group was significantly advanced than that in control group(P<0.05).There were no significant difference in ventilator catheterization time,ICU stay time and postoperative hospitalization time between the two groups(P>0.05).Conclusion Early enteral nutrition support can promote postoperative gastrointestinal motility recovery and improve nutritional status of children patients with CHD.