胰十二指肠切除术后早期肠内营养支持的临床研究

目的 探讨胰十二指肠切除术后早期肠内营养支持的可行性、有效性.方法 胰十二指肠切除患者149例分为对照组(58例)和治疗组(91例).对照组术后常规肠外营养支持,治疗组术后24～48 h开始肠内营养.比较两组间术后并发症发生率、术后一周时血清白蛋白、外周血淋巴细胞计数及体重、术后肛门排气、排便时间和术后住院时间的不同.结果 ①两组间术后并发症发生率、血清白蛋白、外周血淋巴细胞计数及体重等比较均无显著差异;②治疗组术后排气时间(3.8±1.3)d,排便时间(6.2±3.5)d,对照组术后排气时间(5.4±2.1)d,排便时间(7.8±4.2)d,两组间差异均显著(P＜0.05);③治疗组术后住院时间(13.2±3.3)d,对照组术后住院时间(16.2±4.1)d,前者术后住院时间明显短于后者(P＜0.05).结论 胰十二指肠切除术后早期肠内营养是安全可行的,它可促进肠功能恢复,缩短术后住院时间.

A clinical trial in early enteral nutrition after pancreaticoduodenectomy

Objective To study the feasibility and validity in the early enteral nutrition after pancreaticoduodenectomy(PD).Methods 149 cases with PD were divided into the treatment group(n = 91) and the control group(n = 58).The control group was treated with conventional patenteral nutrition,the treatment group was nutrition support with enteral nutrition at 24 ～ 48 hours after operation.The differences of the incidence of postoperative complications,the serum albumin leval 7 days after surgery,the lymphocyte count,the loss of weight,the anus exsufflation time,the defecation time and the hospital stay were compared between two groups.Results ①There were no significant differences in the incidence of postoperative complications,the serum albumin level,the lymphocyte count and the weight change in the groups.②In treatment group,the anus exsufflation time was(3.8 ± 3.1) days and the defecation time was(6.2 ± 3.5) days.But in control group,they were(5.4 ±2.1) days and(7.8 ± 4.2) days respectively.There were obvious differences between two groups(P < 0.05).③In treatment group the hospital stay was(13.2 ± 3.3) days,but in control group,it was(16.2 ± 4.1) days.The former was shorter than the latter(P < 0.05).Conclusion The early enteral nutrition after PD is safer and more feadible,it may promote the recovery of gastrointestinal function and shorten the hospital stay.