水解蛋白在胃肠外科术后的临床应用和护理
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摘要
目的探讨水解蛋白在胃肠外科术后的临床应用价值及其护理措施。方法将32例胃肠手术患者随机分为试验组和对照组。试验组以水解蛋白为主要营养液进行肠内营养支持,以鼻肠管导入胃肠内;对照组以传统标准肠外营养液为主要营养支持,以中心静脉导管滴注提供营养。2组均提供等量的营养物质,比较2组术后8天、14天患者体质量、通气和通便时间、负氮平衡状态、尿中尿素氮排出量、血红蛋白和血浆白蛋白水平及免疫细胞指标CD4+、CD8+、CD4+/CD8+等生理指标。结果试验组通气和通便时间(2.54±0.32)天短于对照组(5.26±0.33)天。试验组在体质量降低、负氮平衡状态、尿中尿素氮排出量、血红蛋白和血浆白蛋白水平升高以及免疫细胞CD4+、CD8+及CD4+/CD8+升高方面均好于对照组。结论水解蛋白作为胃肠外科术后的肠内营养支持物质,能有效改善患者胃肠功能,提高患者机体免疫能力,促进患者恢复,具有良好的临床应用价值。规范的护理措施有利于提高胃肠术后患者对早期水解蛋白肠内营养的耐受性。
Objective To explore the clinical application value and nursing of proteine hydrolysate among postoperative patients with gastrointestinal diseases.Methods 32patients with gastrointestinal diseases were randomly divided into experimental group and control group.The experimental group was given proteine hydrolysate through nasointestinal tube for enteral nutrition support.The control group was given traditional standard nutrient through central venous catheter for parenteral nutrition support.The two groups were offered the same amount of nutrients.The physiological indexes including body weight,ventilation and purgation time,negative nitrogen balance,output of urinary urea nitrogen,hemoglobin and plasma-albumin level,immunocyte CD4 +, CD8 +and CD4 +/CD8 +were observed and compared on the eighth and fourteenth day after operation.Results The ventilation and purgation time in the experimental group(2.54±0.32days) was significantly shorter than that in the control group(5.26±0.33days).The body weight decrease,negative nitrogen balance,urinary urea nitrogen output,hemoglobin and plasma-albumin level increase and CD4 +,CD8 +and CD4 +/CD8 +increase in the experimental group were better than that in the control group.Conclusion As the material of postoperative enteral nutrition support, proteine hydrolysate can improve gastrointestinal function,enhance immunologic competence, promote recovery of patients and have a better clinical application value.Effective nursing practice can improve proteine hydrolysate's tolerance among postoperative patients with gastrointestinal diseases.
Objective To explore the clinical application value and nursing of proteine hydrolysate among postoperative patients with gastrointestinal diseases.Methods 32patients with gastrointestinal diseases were randomly divided into experimental group and control group.The experimental group was given proteine hydrolysate through nasointestinal tube for enteral nutrition support.The control group was given traditional standard nutrient through central venous catheter for parenteral nutrition support.The two groups were offered the same amount of nutrients.The physiological indexes including body weight,ventilation and purgation time,negative nitrogen balance,output of urinary urea nitrogen,hemoglobin and plasma-albumin level,immunocyte CD4 +, CD8 +and CD4 +/CD8 +were observed and compared on the eighth and fourteenth day after operation.Results The ventilation and purgation time in the experimental group(2.54±0.32days) was significantly shorter than that in the control group(5.26±0.33days).The body weight decrease,negative nitrogen balance,urinary urea nitrogen output,hemoglobin and plasma-albumin level increase and CD4 +,CD8 +and CD4 +/CD8 +increase in the experimental group were better than that in the control group.Conclusion As the material of postoperative enteral nutrition support, proteine hydrolysate can improve gastrointestinal function,enhance immunologic competence, promote recovery of patients and have a better clinical application value.Effective nursing practice can improve proteine hydrolysate's tolerance among postoperative patients with gastrointestinal diseases.
引文
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[2]王辰,黄慧玲,莫丽冬,等.脑蛋白水解物中多肽组分的高效毛细管电泳分析.中国医药,2012,7(5):603-605.
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[6]Artinian V,Krayem H,DiGiovine B.Effects of Early Enteral Feeding on the Outcome of Critically Ill Mechanically Ventilated Medical Patients.Chest,2006,129(4):960-967.
[7]Chen DW,Wei FZ,Zhang YC,et al.Role of Enteral Immunonutrition in Patients with Gastric Carcinoma Undergoing Major Surgery.Asian J Surg,2005,28(2):121-124.
[8]Rutherfurd-Markwick KJ,Moughan PJ.Bioactive Peptides Derived from Food.J AOCO Int,2005,88(3):955-966.
[9]鱼晓波,阮征,黄海龙,等.食管癌术后早期肠内营养支持的疗效研究.中国医药,2012,7(11):1396-1399.
[10]Wildhasber BE,Yang H,Spencer AU,et al.Lack of enteral nutrition-effects on the intestinal immune system.J Surg Res,2005,123(1):8-16.
[11]Marshall AP,West SH.Enteral feeding in the critically ill:are nursing practices contributing to hypocaloric feeding?Intensive Crit Care Nurs,2006,22(2):95-105.
[2]王辰,黄慧玲,莫丽冬,等.脑蛋白水解物中多肽组分的高效毛细管电泳分析.中国医药,2012,7(5):603-605.
[3]Colomb V,Goulet O.Nutrition support after intestinal transplantation:how important is enteral feeding?.Curr Opin Clin Nutr Metab Care,2009,12(2):186-189.
[4]Marik PE,Zaloga GP.Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis.BMJ,2004,328(7453):1407-1417.
[5]Martindale RG,Mcciave SA,Vanek VW,et al.Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient:Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition:Executive Summary.Critical Care Medicine,2009,37(5):1757-1761.
[6]Artinian V,Krayem H,DiGiovine B.Effects of Early Enteral Feeding on the Outcome of Critically Ill Mechanically Ventilated Medical Patients.Chest,2006,129(4):960-967.
[7]Chen DW,Wei FZ,Zhang YC,et al.Role of Enteral Immunonutrition in Patients with Gastric Carcinoma Undergoing Major Surgery.Asian J Surg,2005,28(2):121-124.
[8]Rutherfurd-Markwick KJ,Moughan PJ.Bioactive Peptides Derived from Food.J AOCO Int,2005,88(3):955-966.
[9]鱼晓波,阮征,黄海龙,等.食管癌术后早期肠内营养支持的疗效研究.中国医药,2012,7(11):1396-1399.
[10]Wildhasber BE,Yang H,Spencer AU,et al.Lack of enteral nutrition-effects on the intestinal immune system.J Surg Res,2005,123(1):8-16.
[11]Marshall AP,West SH.Enteral feeding in the critically ill:are nursing practices contributing to hypocaloric feeding?Intensive Crit Care Nurs,2006,22(2):95-105.