| 葛华,何学彦,黄永生.老年上消化道穿孔术后早期肠内营养与肠外营养的临床效果比较[J].安徽医药,2018,22(12):2379-2382. |
| 老年上消化道穿孔术后早期肠内营养与肠外营养的临床效果比较 |
| Comparation of clinical effects of early enteral nutrition and parenteral nutrition on older patients with upper digestive tract perforation afer operation |
| 投稿时间：2017-03-18 |
| DOI： |
| 中文关键词: 老年 上消化道穿孔 肠内营养 肠外营养 |
| 英文关键词: Older Upper digestive tract perforation Early enteral nutrition Parenteral nutrition |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨老年上消化道穿孔术后早期肠内营养对患者恢复的影响。 方法 将60例老年上消化道穿孔的患者根据其术后不同的营养方式随机分为两组,观察组30例术后给予早期肠内营养支持,对照组30例术后按传统治疗方案给予全肠外营养。对比分析两组患者术前及术后第3、7天患者胃肠道功能恢复的情况、住院时间、住院费用、术后并发症的发生率、营养和免疫状况等。 结果 术前两组患者的体质量、体质量指数、总蛋白、前白蛋白以及白蛋白水平均差异无统计学意义(P＞0.05)；术后第3、7天上述各指标两组均出现下降,其中术后第3天观察组体质量、总白蛋白水平高于对照组,术后第7天各项营养指标在对照组与观察组均差异有统计学意义(P＜0.05)；术前两组患者的C3、C4、IgG水平均无差异无统计学意义(P＞0.05)；术后第3天上述各指标与术前相比两组均出现下降,IgG水平在对照组术后第7天仍低于术前；组间比较发现补体C4和IgG水平在术后第3天观察组恢复较好,且术后第7天各免疫指标观察组恢复情况优于对照组(P＜0.05)；观察组患者在术后感染性并发症、死亡率、腹胀等与对照组相比差异无统计学意义；术后首次肛门排气时间、住院时间和住院总费用观察组均短于或低于对照组,差异有统计学意义(P＜0.05)。结论 老年上消化道穿孔术后早期肠内营养能加速术后肠道功能的恢复,提高营养状况和免疫功能,缩短术后住院时间,降低住院费用,具备较高的安全性、有效性,有着良好的临床应用价值和前景。 |
| 英文摘要: |
| Objective To evaluate the effect of enteral nutrition on older patients with upper digestive tract perforation afer operation. Methods Sixty older patients with upper digestive tract perforation were randomly divided into 2 groups according to their different ways of nutrition.Treatment Group(30 cases) accepted early enteral nutrition management.Control Group(30 cases) accepted parenteral nutrition management.The resumption of gastrointestinal function,hospital stay,hospital charge,complications,nutritional and immune status before operation and on day 3,7 ofter operation were analyzed. Results There were no differences on levels of body weight,body mass index,total protein,serum albumin and prealbumin before operation between the 2 groups(P>0.05).On day 3 and day 7 after operation,the above levels were significantly low in both groups,and the Control Group was decreased more obivious than Treatment Group,espicially on day 7 after operation(P<0.05).There were significant differences on levels of body weight and serum albumin on day 3 after operation between the 2 groups(P<0.05).The nutritional status in treatment group were better than control group on day 7 after operation(P<0.05).On day 7 after operation,the C3,C4 and IgG levels in treatment group were higher than control group,the levels of C4 and IgG were decreased more obvious in control group on day 3 after operation.The postoperative complications,death rate and ventosity of the two groups showed no significant difference.Compared with Control Group,the time for bowel flatus,hospital stay and hospital charges were reduced in Treatment Group(P＜0.05). Conclusions Early enteral nutrition for the older patients with upper gastrointestinal perforation after operation can be effective to improve the nutrition and immune status,reduce the hospital stay and hospital charges.EEN is safe and efficient,and has very high clinical value. |
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