胃肠道术后瑞素早期肠内营养的应用

Early enteral nutrition with Fresubin after gastrointestinal operation

目的 :观察胃肠道术后瑞素 (Fresubin)早期肠内营养支持的效果。 方法 :选择胃肠道手术后病人共 78例 ,分成两组 ,A组为空肠造口管组 ,B组为对照组。A组应用肠内营养输注系统 ,在手术后 6h开始均匀输注瑞素 ,观察肠内营养支持期间的临床表现 ,并测定肠内营养支持前、后病人的血常规、血糖、肝肾功能、电解质和营养指标 ,以及术后并发症。 结果 :术后肛门排气恢复时间A组比B组早 (P <0 .0 1) ;A组应用瑞素后 1例出现恶心、呕吐 ,经减慢输注速度后缓解 ,2例出现腹痛 ,经调整温度后缓解。所有病人没有出现腹泻、急性机械性肠梗阻、肠瘘和代谢性并发症。A组应用瑞素后 ,前白蛋白比B组升高 (P <0 .0 5 ) ,视黄醇结合蛋白也比B组明显升高 (P <0 .0 1)。 结论 :胃肠道术后通过空肠造口管应用瑞素进行早期肠内营养支持是安全有效的 ,有利于胃肠功能的恢复 ,对改善病人机体的营养状况具有积极意义 。

Objectives: To study the effect of early enteral nutrition using Fresubin after gastrointestinal operation. Methods:78 postoprative patients were divided into two groups. The jejunostic tube group(A group, n=50) received the enteral nutrition(Fresubin) 6h after operation, and the control group(B group, n=28)received the intravenous infusion and then the oral liquid diet after the bowel movement recovery.The clinical findings,operative complications,blood glucose,the function of liver and kidney,electrolytes and nutritional status were observed. Results:The recovery of bowel movement in group A was much earlier than that in group B(P<0.01).Nausea and vomiting occured in one patient and relieved by slowing the administration rate in group A.Abdominal pain occurred in two patients and relieved by regulating the temperature of Fresubin in group A.No patient had the complications such as diarrhea,intestinal obstruction,intestinal fistula and metabolic disorder in group A and the levels of prealbumin and RBP were significantly higher in group A than those in the control group. Conclusions:Using Fresubin for early enteral nutrition through jejunostic tube is safe and effective after gastrointestinal operation.It is beneficial to the recovery of gastrointestinal function and has a positive role in improving the patients’ nutritional status.