摘要
目的 :探讨风湿性心脏病 (简称风心病 )合并心源性恶病质病人围手术的营养支持与手术预后的关系。 方法 :35例风心病合并心源性恶病质的病人分成两组 (营养组和对照组 ) ,术前测定两组病人营养支持治疗前后体重指数 (BMI)、血清营养指标参数、总淋巴细胞计数 (TLC) ,观察手术后心包、纵隔引流液量、机械通气时间、并发症发生率和病死率。 结果 :营养组和对照组在术前治疗前的各参数无统计学意义。经治疗后营养组与对照组比较BMI、血清营养指标参数、TLC明显增加 (P <0 .0 5 ) ,血清总胆红素明显下降 (P <0 .0 5 ) ,多巴胺用量及心包纵隔引流液量明显减少 (P <0 .0 5 ) ,机械通气时间、ICU时间、住院时间明显缩短 (P <0 .0 5 ) ,并发症明显减少 (P <0 .0 5 )。死亡 2例均为对照组病人。 结论 :术前的营养支持能明显改善风心病恶病质综合征 (SOCC)瓣膜病病人的心功能及全身营养状况 ,缩短术后的机械通气时间及住院时间 ,减少心包、纵隔引流液量 ,促进切口的愈合 ,降低术后并发症 。
Objectives: To study the relationship between the operative prognosis and the perioperative nutritional support of patients with rheumatic heart disease associated cardiac cachexia. Methods:Thirty five patients with rheumatic heart disease associated cardiac cachexia were divided into two groups, preoperative nutritional support for eight to fourteen days in 20 patients (nutritional group), and preoperative free eating and intravenous drip heart GIK solution (placebo) for one to two weeks in 15 patients (control group). Preoperative body mass index (BMI), plasma nutritive parameter, total lymphocyte count before and after nutritional support or placebo were measured, and postoperative pericardium and mediastina drainage, mechanical ventilation time, incidence of complications and mortality rate were observed. Results:There isn′t statistics significance about preoperative various parameters before therapy between nutritional group and control group. In nutritional group, the BMI, plasma nutritive parameter, and total lymphocyte count increased significantly compared with control group, postoperative dopamine dosage and pericardium and mediastina drainage were significantly junior to control group, postoperative mechanical ventilation time, intensive care unit time, hospital stay time were significantly shorter than control group, and postoperative complications were significantly lower than control group. two death cases were found in control group. Conclusions:Preoperative nutritional support can obviously improve cardiac function and total body nutritional status of patients with rheumatic heart disease associated cardiac cachexia, shorten postoperative mechanical ventilation time and hospital stay time, decrease the postoperative pericardium and mediastina drainage, stimulate incision concrescence, cut down postoperative complications, and enhance operative survival rate.
出处
《肠外与肠内营养》
CAS
2003年第4期206-209,共4页
Parenteral & Enteral Nutrition
