三腔胃肠管在上消化道穿孔早期肠内营养中的应用
摘要
目的探讨三腔胃肠管在上消化道穿孔早期肠内营养中的应用。方法选取2017年1月至2018年12月,我院收住的60例上消化道穿孔患者,随机分成实验组30例、对照组30例,并排除年龄、性别、体重、身高等因素影响,即两组患者在年龄、性别、体重、身高等均无统计学差异,具有可比性;对照组即采用传统的胃肠减压联合全胃肠外营养治疗方式,实验组即采用三腔胃肠管联合早期肠内营养治疗方式。结果实验组与对照组术前各营养指标(血清总蛋白、血清白蛋白、血红蛋白)水平相比差异无统计学意义(P>0.05);术后第7天两组患者营养指标分析,两组患者各营养状况指标均较术前下降,对照组下降更加明显,且实验组各项指标均高于对照组,组间比较差异有统计学意义(P<0.05),两组患者住院时间比较中,实验组住院时间明显短于对照组,P<0.05,平均住院费用中,实验组住院费用低于对照组,P<0.05,说明早期肠内营养能缩短患者住院时间,并能降低患者住院费用;而在术后并发症(如恶心、呕吐、腹泻、置管肺炎等)、术后三天胃引流量上,实验组与对照组对比无明显差异,P>0.05,无统计学意义。结论三腔胃肠管在上消化道穿孔早期实施肠内营养是有效可行的,对于上消化道穿孔患者早期肠内营养优于肠外营养,可早期给予肠内营养。
引文
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[12]尹路,陈杜明,钱德健,等.三腔胃肠管在上消化道手术中的应用价值[J].肠外与肠内营养,2005,12(3):177-180.
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[15]Hochwald SN,Harrison LE,Heslin M J,et al.Early postoperative enteral feeding improves whole body protein kinetics in upper gastrointestinal cancer patients[J].American Journal of Surgery,1997,174(3):325-330.
[2]李公明,刘自立,王建华,等.腹腔镜治疗消化道穿孔65例临床观察[J].中国实用医药,20131,6(21):129-130.
[3]余春,毛兴龙,林水泉,等.加速康复外科理念在腹腔镜上消化道穿孔修补术中的应用[J].肠外与肠内营养,2013,20(3):139-141.
[4]唐艺,何云,欧阳正晟.早期肠内外营养对全胃切除术的营养免疫及肝功能的影响[J].海南医学院学报,2013,19(4):514-516.
[5]Kang WM,Yu JC,Zhang Q,et al.Effects of enteral and parenteral nutrition on gastroenteric hormones and gastric motility after subtotal gastrectomy[J].Chin Med Sci J,2008,23(2):113-116.
[6]钟海辉,刘汉云,张焕荣.早期肠内营养在食管癌术后患者中的应用效果[J].中国实用医刊,2015,42(2):96-97.
[7]Johnson AT,Kaufmann Y,Luo S,et al.Gut glutathione metaboilism and changes with 7,12-DMBA and glutamine[J].HJ Surg Res,2003,115(2):242-246.
[8]Cai L,Zhang ZL,Zhang ZF,et al.Risk factors for the gastric cardia cancer:a case-control study in Fujian province[J].World J Gastroenterol,2003,9(2):214-218.
[9]Braga M,Gianotii L,Gentilini O,et al.Feeding the gut early after digestive surgery:results of a nine-year experience[J].Clin Nutr,2002,21(1):59-65.
[10]Hsu MH,Yu YE,Tsai YM,et al.Combined enteral feeding and total parenteral nutritional support improves outcome in surgical intensive care unit patients[J].J Chin Med Assoc,2012,75(9):459-463.
[11]赵明利,薛琪,李雅男,等.腹腔镜结肠癌术后早期口服肠内营养的临床观察[J].中华胃肠外科杂志,2013,16(11):1041-1044.
[12]尹路,陈杜明,钱德健,等.三腔胃肠管在上消化道手术中的应用价值[J].肠外与肠内营养,2005,12(3):177-180.
[13]Lewis SJ,Egger M,Sylvester PA,et al.Early enteral feeding versus“nil by mouth”after gastrointestinal surgery:systematic review and meta-nanlysis of controlled trials[J].BMJ,2001,323(7316):773-776.
[14]Rayes N,Hansen S,Seehofer D,et al.Early enteral supply of fiber and lactobaeilli versus conventional nutrition:a controlled trial in patients with major abdominal surgery[J].Nutrition,2002,18(7-8):609-615.
[15]Hochwald SN,Harrison LE,Heslin M J,et al.Early postoperative enteral feeding improves whole body protein kinetics in upper gastrointestinal cancer patients[J].American Journal of Surgery,1997,174(3):325-330.