摘要
目的 :对比不同营养方式下肝移植术后细菌、真菌感染率 ,与感染直接相关的病死率和感染部位分布等情况 ,寻找肝移植术后降低感染率方面更恰当的营养方式。 方法 :对 132例术前营养评估为中、重度营养不良的原位肝移植病人按时间段分为两组 ,第 1组 6 3例 ,术后实行全胃肠外营养 (TPN) 1周 ;第 2组 6 9例 ,术后第 2天起采取部分肠内营养 (EN)加肠外营养 (PN) ,再逐步向完全EN(TEN)过渡 ,比较两组病人细菌和真菌感染率、与感染直接相关的病死率和感染部位分布比例。 结果 :EN加PN组较TPN组病人肝移植术后真菌、细菌、肠道真菌和原发性血行细菌感染率均明显下降 (P <0 .0 5 ) ;EN加PN组与感染直接相关的病死率较TPN组有下降 ,但两组无显著差异(P >0 .0 5 )。 结论 :对于术前合并中、重度营养不良的病人 ,肝移植术后早期应用EN加PN ,再逐步向TEN过渡的方法在预防感染方面明显优于TPN。
Objectives:To investigate the relationship between nutritional therapies and infection after liver transplantation. Methods:132 sequential orthotopic liver transplants were reviewed with moderate to severe malnutrition before liver transplantation bwtween January 1998 and December 2002.One group of 63 patients were given total parenteral nutritional therapy for one week after liver transplantation.And another group of 69 patients were given combination nutritional therapy(EN+PN) for five days followed by total EN.The rate of infection,mortality related to the infection and infection site were compared between two groups. Results:The infection rate was decreased significantly in the group received EN+PN treatment( P <0.05).The mortality related to infection was also lower in the EN+PN group, but no statistical significance( P >0.05). Conclusions:The use of combination of EN+PN has an advantage over total parenteral nutritional therapy in the prevention of postoperative infection and is the optimal method of nutritional support in the liver transplanted patients with moderate to severe malnutrition before transplantation.
出处
《肠外与肠内营养》
CAS
2003年第2期97-99,102,共4页
Parenteral & Enteral Nutrition
关键词
肝移植
营养支持
感染率
Orthotopic liver transplantation
Nutritional support
Infection
