围手术期序贯性肠内营养在肝段切除患者中的应用及护理

Application and Nursing Care of Sequential Enteral Nutrition during Perioperative Period in Patients Undergoing Segmental Hepatectomy

目的:探讨肝段切除患者围术期应用序贯性肠内营养支持的临床效果及护理方法。方法:以2018年1月-2020年5月笔者所在医院行肝段切除手术的52例患者为研究对象,随机分为两组。对照组26例,围术期予以全肠外营养支持;试验组26例,围术期予以序贯性肠内营养支持。比较观察两组干预前后身体状况指标:体重、上臂肌围(MAMC)与肱三头肌皮肌褶皱厚度(TSF),营养指标血红蛋白(Hb)、白蛋白(Alb)与前白蛋白(PAB)变化,观察两组排气、排便时间,评价肠道功能恢复情况。结果:干预后,试验组体重(59.16±4.30)kg,MAMC(22.94±1.95)mm,TSF(14.57±2.86)mm,均优于对照组,差异有统计学意义(P<0.05)。试验组血Hb(128.10±12.77)g/L,Alb(35.60±3.14)g/L,PAB(198.95±16.73)mg/L,均优于对照组,差异有统计学意义(P<0.05)。试验组排气、排便时间均早于对照组,差异有统计学意义(P<0.05)。结论:肝段切除围术期应用序贯性肠内营养支持,可以更好维持患者营养状况,促进患者胃肠功能恢复,改善预后。

Objective:To explore the clinical effects and nursing methods of sequential enteral nutrition support in patients with segmental hepatectomy.Method:From January 2018 to May 2020,52 patients who underwent hepatectomy in our hospital were taken as the research objects and randomly divided into two groups.In the control group,26 cases received total parenteral nutrition support during the perioperative period;26 cases in the test group received sequential enteral nutrition support during the perioperative period.Compared and observed the physical conditions of the two groups before and after intervention,body weight,upper arm muscle circumference (MAMC) and triceps cutaneous muscle fold thickness (TSF),nutritional indicators hemoglobin (Hb),albumin (Alb) and prealbumin (PAB) Change,observed the exhaust and defecation time of the two groups,and evaluated the recovery of intestinal function.Result:After intervention,the weight[(59.16±4.30) kg],MAMC[(22.94±1.95) mm],and TSF[(14.57±2.86) mm]of the test group were better than those of the control group,and the difference was statistically significant (P<0.05).The blood Hb[(128.10±12.77) g/L],Alb[(35.60±3.14) g/L],and PAB[(198.95±16.73) mg/L]of the test group were better than those of the control group,and the difference was statistically significant (P<0.05).The exhaust time of the experimental group was (42.15±14.22) h,which was shorter than that of the control group,and the difference was statistically significant (P<0.05).Conclusion:The application of sequential enteral nutrition support during the perioperative period of hepatectomy can better maintain the nutritional status of patients,promote the recovery of patients’ gastrointestinal function,and improve the prognosis.