摘要
目的 :探讨肠内营养在消化道肿瘤病人术后早期应用及其影响。方法 :消化道肿瘤病人 (n =6 3)术后按热卡 30kal/kg/d给予全量的 2 / 3,术后第 4～ 7天给予全量。所有病例均在术前和术后第 7天测定全血图、肝功、肾功、电解质、前白蛋白 (PA)、转铁蛋白 (TRF)、血糖 (Glu)、胆固醇 (Chol)和甘油三酯 (TG) ;同时记录腹胀、腹痛、腹泻、恶心、呕吐、便秘及大便情况。结果 :术后营养指标与术前比较均有下降 ,总蛋白 (TP)、白蛋白 (ALB)和TRF下降明显 (P <0 0 5 ) ,其余营养指标虽有下降 ,但是差异不显著 (P >0 0 5 )。术前、术后比较肝、肾功和电解质测定各指标值变化差异不显著 (P >0 0 5 )。术后第 7天空腹血糖与术前空腹血糖比较差异有显著性 (P <0 0 5 )。术后胆固醇、甘油三酯均有下降 ,与术前比较差异显著 (P <0 0 5 )。结论 :肠内营养制剂安素在消化道肿瘤病人术后早期肠内应用是安全、可行的 ,并能明显改善机体的营养状态 ,促进和维护胃肠道功能 ,预防感染性并发症的发生。
Objective:To explore the early enteral nutrition(EN)with energy supply after gastrointestinal neoplasm surgery.Methods:Postoperative patients with gastrointestinal neoplasm received one third of full load of EN provided 30kal/kg/d energy via jejunostomy or nasogastric tube on the first 24 hours postoperatively,then half of the full load on postoperative day 2,two thirds of full load on postoperative day 3,and full load on postoperative day 4～7.Assessments included blood cell count,liver and renal function,electrolyte,prealbumin(PA),transferring(TRF),glucose,cholesterol(Chol)and triglyceride(TG)preoperative and postoperative day 7,occurrence of abdominal distention,abdominal pain,diarrhea,nausea,vomit,constipation were recorded.Results:There's significant difference in pre-and postoperative total protein(TP),albumin(Alb),TRF(P<0.05).The other indices decreased also,but not significantly(P>0.05).The difference of the changes in pre-and postoperative blood cell count,liver and renal function,electrolyte are not apparent(P>0.05).The difference in preoperative and postoperative glucose,cholesterol and TG is apparent(P<0.05,glucose increased,cholesterol and TG both decreased).Conclusion:EN is safe and practicable in early postoperative patients with gastrointestinal neoplasm,and may improve the nutritional status,with gastrointestinal function improvement,prevent infection complications.
出处
《华西医学》
CAS
2004年第1期60-61,共2页
West China Medical Journal
