早期肠内营养对肝移植患者术后肝功能恢复的影响

The Effect of Early Enteral Nutrition on the Recovery of Liver Function After Liver Transplantation

目的分析早期肠内营养对肝移植患者术后肝功能恢复的影响。方法选择2017年1月~2020年12月我院收治的肝移植术后患者75例,根据不同营养方式分为术后全肠外营养组(TPN组)37例和术后早期肠内营养联合肠外营养组(EN+PN组)38例,比较两组术前1天、术后第1、3、5、7天肝功能检查(TP、ALB)变化。结果EN+PN组术后第1天、术后第5、7天TP高于TPN组,差异有统计学意义(P<0.05);TPN组术前1天、术后第3天TP高于EN+PN组,但差异无统计学意义(P>0.05);EN+PN组术后第5天ALB水平高于TPN组,差异有统计学意义(P<0.05);TPN组术后第1、3、7天ALB水平高于EN+PN组,但差异无统计学意义(P>0.05)。结论肝移植术后患者EN+PN较TPN是更健康、更合理的营养支持方法,可促进术后肝功能恢复,因此,针对肝移植术后的患者,若无明显肠内营养禁忌症,应早期给予充分的肠内营养支持。

Objective To analyze the effect of early enteral nutrition on the recovery of liver function after liver transplantation.Methods 75 patients after liver transplantation admitted to our hospital from January 2017 to December 2020 were selected.According to different nutrition methods,they were divided into 37 cases in the postoperative total parenteral nutrition group(TPN group)and 38 cases in the early postoperative enteral nutrition combined with parenteral nutrition group(EN+PN group).The changes of liver function tests(TP,ALB)on the first day before operation and the first,third,fifth,and seventh day after operation were compared between the two groups.Results TP in EN+PN group was higher than TPN group on the first day,5th and 7th day after operation,the difference was statistically significant(P<0.05);The TP of the TPN group was higher than that of the EN+PN group on the first day and the third day after the operation,but the difference was not statistically significant(P>0.05);The ALB level of EN+PN group was higher than TPN group on the 5th day after operation,the difference was statistically significant(P=P<0.05);The ALB level in the TPN group was higher than that in the EN+PN group at 1,3,and 7 days after surgery,but the difference was not statistically significant(P>0.05).Conclusion EN+PN is a healthier and more reasonable nutritional support method for patients after liver transplantation than TPN,which can promote postoperative liver function recovery.Therefore,for patients after liver transplantation,if there is no obvious contraindication to enteral nutrition,adequate enteral nutrition support should be given early.