摘要
目的 :探讨Flocare空肠造口管在术后早期肠内营养中应用的可行性 ,并比较肠内与肠外营养的效果。方法 :33例胃、直肠术后病人随机分为早期肠内营养 (EN)和完全胃肠外营养 (TPN)两组 ,分别为 18例及 15例。EN组在术中行Flocare可裂式套管空肠造口术 ,术后第二日经造口管输注肠内营养剂液体能全力 ,维持 7～ 8d。TPN组经外周静脉进行 ,维持 5d。结果 :EN组与TPN组在血红蛋白、淋巴细胞总数、白蛋白、总胆红素参数统计分析无显著性差异 (P >0 .0 5 )。在血碱性磷酸酶水平 ,EN组手术前后无显著变化 ,而TPN组术后高于术前 (P <0 .0 5 )。EN组在前白蛋白、转铁蛋白手术前后无明显差异 (P >0 .0 5 )。多数患者均可耐受早期肠内营养 ,EN组术后肠蠕动恢复平均为 2 .37± 0 .85d ,短于TPN组 3.0 7± 1.2 8d(P <0 .0 5 )。结论 :①Flocare导管造口术相对于传统方法—切开空肠置入导管的方法而言 ,技术上有重大改进 ,在临床上使用便捷 ,值得推行 ;②早期肠内营养的应用有助于肠蠕动较早恢复 ,减少对肝功能的影响 ,与PN相比具有更符合生理、安全、有效、价廉等优点。
Objective: To evaluate the feasibility of Flocare jejunal feeding tube in early postoperative enternal nutrition(EEN) and compare metabolic effects of EEN versus total parenteral nutrition(TPN). Methods: Thirty-three patients undergone gastrointestinal surgery were randomly divided into EEN group(n=18) and TPN group(n=15). The eighteen patients in EEN group had a jejunal feeding tube displayed by jejunostomy during the operation. The enteral feeding was started with in the first 24 hours postoperatively with nutrison fibre and continued for consecutive 7～8 days. In fifteen patients of TPN group total parenteral nutrition was provided via peripheral vein for 5 days. Results: There were no significant differences between the two groups in HB, LYM, albumin, TB(P>0.05). Serum level of alkaline phosphatase(AKP) was increased significantly after operation in TPN group(P<0.05), whereas no such change was observed in EEN group. Serum levels of prealbumin(PAB) and transferrin(TF) maintained stable in EEN group(P>0.05). The cost of enteral nutrition was significantly lower than that of standard PN. The audible bowel sounds and bowel movement recovered significantly earlier in EEN group than in TPN groups(P<0.05). Conclusions: The early postoperative enteral nutrition was well tolerated in the patients undergone gastrointestinal surgery. Compared with the traditional jejunostomy, Flocare jejunal feeding tube is more convenient and feasible with improved technique. In comparison with TPN, the application of early enteral nutrition may promote the bowel function with less disturbance on liver function.
出处
《河北医学》
CAS
2003年第9期787-790,共4页
Hebei Medicine
关键词
肠内营养
空肠造口
术后
Enteral nutrition
Flocare jejunal feeding tube
Postoperation
