个体化肠外营养在肠切除伴肠功能障碍患者中的应用研究

Application of individualized parenteral nutrition in patients with intestinal resection and intestinal dysfunction

目的探讨个体化肠外营养在肠切除伴肠功能障碍患者中的应用效果。方法采用单中心前瞻性随机对照试验研究方法,纳入2020年1月至2022年12月在苏州市中西医结合医院诊治的80例肠切除伴肠功能障碍为研究对象,按照随机数字表法分为观察组(40例)和对照组(40例)。对照组接受临床常规营养干预,观察组接受个体化肠外营养干预。对比干预后两组肠功能恢复指标、营养指标、术后并发症以及住院天数等指标。结果观察组在肠鸣音恢复时间、首次排气时间、首次排便时间均明显早于对照组,差异有统计学意义(P<0.05)。两组在不同时间点体重指数、握力、上臂肌围、肱三头肌皮褶厚度方面比较,差异均无统计学意义(P>0.05)。观察组术后3 d、7 d的血清白蛋白、前白蛋白、血红蛋白水平明显好于对照组(P<0.05),两组在其他时间点比较,差异无统计学意义(P>0.05)。两组在术后吻合口瘘、腹胀、恶心呕吐、感染以及并发症总数方面对比,差异无统计学意义(P>0.05)。观察组住院天数明显短于对照组(P<0.05)。结论个体化肠外营养应用在肠切除伴肠功能障碍患者中,能够促进肠功能恢复,改善术后早期实验室检查指标,缩短住院时间。

Objective To explore the application effect of personalized parenteral nutrition in patients with intestinal resection and intestinal dysfunction.Methods A single center prospective randomized controlled trial was used,80 cases of intestinal resection with intestinal dysfunction diagnosed and treated in Suzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2020 to December 2022 were included as the study subjects.They were randomly divided into observation group(40 cases)and control group(40 cases)according to the random number table method.The control group received routine clinical nutrition intervention,while the observation group received individualized parenteral nutrition intervention.The recovery indicators of intestinal function,nutritional indicators,postoperative complications,and hospitalization days between the two groups after intervention were compared.Results The observation group showed significantly earlier recovery time of bowel sounds,first exhaust time,and first defecation time than the control group,with statistically significant differences(P<0.05).There were no statistically significant differences between the two groups in body mass index,grip strength,upper arm muscle circumference and triceps skinfold thickness at different time points(P>0.05).The observation group showed significantly better levels of serum albumin,prealbumin,and hemoglobin compared to the control group at 3 and 7 days after surgery,with statistically significant differences(P<0.05).However,there was no statistically significant difference between the two groups at other time points(P>0.05).There was no statistically significant difference between the two groups in terms of postoperative anastomotic leakage,abdominal distension,nausea and vomiting,infection,and total number of complications(P>0.05).The hospitalization days in the observation group were significantly shorter than those in the control group,with a statistically significant difference(P<0.05).Conclusion The application of personalized parenteral nutrition in patients with intestinal resection and intestinal dysfunction can promote intestinal function recovery,improve early postoperative laboratory examination indicators,and shorten hospital stay.