早期营养干预对先天性心脏病患儿术后的影响

Effect of early nutritional support on congenital heart disease patients after surgery

目的探讨早期营养干预对先天性心脏病患儿术后的影响。方法采用随机对照法,将116例手术治疗的先心病患儿分成实验组和对照组。实验组患儿在术后12小时开始行肠内营养支持治疗,对照组患儿于气管插管拔除6小时,胃肠功能恢复后开始进食或鼻饲。比较两组患儿ICU住院时间、呼吸机辅助时间、呼吸机相关性肺炎发生率、术后住院时间、并发症发生率,并监测治疗前和治疗后第14天的血清总蛋白、清蛋白、前清蛋白及C反应蛋白变化。结果实验组病人呼吸机辅助通气时间、术后住院时间和并发症发生率低于对照组(P<0.05);实验组组病人治疗第14天后,血清ALB、PA水平与治疗前和对照组比均有差异(P<0.05),C反应蛋白下降明显快于对照组(P<0.05)。结论对先天性心脏病患儿术后进行早期营养干预,可以改善患儿营养状况、缩短住院时间,减少并发症发生。

Objective To investigate the effects of early nutritional support on postoperative patients with congenital heart disease.Methods Using randomized controlled methods,116 patients received congenital cardiac operation were divided into two groups.In the testing group patients received enteral nutrition support in 12 h after operation,while those in the control group did in 6 h after tracheal extubation and gastrointestinal functional recovery.In two groups severe patients received parenteral alimentation on the third day after surgery.The clinical efficacy of two groups total protein,serum albumin,prealbumin,C-reactive protein,the incidence of VAP and complication,mechanical ventilation,postoperative hospital stay and ICU stay time were compared.Results Mechanical ventilation time,hospitalization days and the incidence of complications were also significantly reduced in the test group(P<0.05).Serum albumin and prealbumin level were significantly improved and C-reactive protein was significantly decreased(P<0.05)in the test group.Conclusion Early nutritional support can improve the nutrition rehabilitation and reduce the incidence of complications in postoperative.