术后早期应用肠内营养五例报告
作者：张戈
单位：辽宁开原市第一医院
关键词：
中国临床营养杂志000154摘 要：目的总结术后早期(24～36小时)肠内营养应用的经验，疗效及并发症。 方法总结三年来我院实施5例术后早期肠内营养的方法、疗效及并发症。 结果5例术后早期肠内营养的病人疗效满意，病人营养状况改善，体重增加，原发病(2例高位肠痿，3例胰、十二指肠、脾等脏器损伤)均治愈。5例中仅一例出现恶心，予对症治疗后缓解，2例高位肠痿应用肠内营养4周痊愈出院。3例多发脏器损伤应用肠内营养7～10天，均于2周出院。无感染发生。 结论本组资料显示，术后早期应用肠内营养，既能改善病人营养状况，又可保护肠粘膜屏障作用，是防止术后感染的方法之一。
Analysis of the post-operative earlier enteral nutrition support in surgically-stressed patients
, http://www.100md.com
ZHANG Ge
(The First Hospital of)
Abstract：Objective It has been demonstrated that para-operative fasting often induce gastrointestinal mucosal atrophy, that, together with the surgically-stress effects, deteriorate the intestinal harrier structure and may further cause gut-origin infection. Parenteral nutrition has been widely employed in the patients undergone surgery or with trauma as a standard nutritional support in many hospitals. It can provide sufficient nutrients, including calories, nitrogen, and minerals for the daily and extra needs during the stress. However, numbers of investigations have proven that long term parenteral nutrition support has no effects on preventing intestinal mucosa atrophy, but indeed, consistently result in down-regulation of mucosal structure. It has been widely accepted in the clinic that enteral nutrition should be chosen as a priority mean, as to parenteral nutrition, to support the patients whenever they can tolerant. However, there are few reports concerning earlier use of enteral nutrition in post-operative patients. The purpose of this study was to evaluate the effects of postoperative earlier enteral nutrition support (24～36 hours) on the patients undergone major surgery. The cases with earlier enteral nutrition feeding during last three years were reviewed and the feeding method, the effectiveness, and the complications of earlier feeding were investigated. In five cases, with two of proximal small intestine fistula, three of pancreas, duodenal injury, the total effectiveness was satisfactory. All patients gained wight and the nutritional states were much improved. The initial disease of the patients with earlier feeding were all cured within the time periods which were significantly shorter than those who had ordinary post-operative feeding. Only one case among five had mild nausea during the feeding, and was settled after anti-nauseas medications. Two cases with proximal small intestine fistula were recovered in four weeks time. We thus conclude that earlier enteral feeding post-operatively is a safe and effective method for those who have major surgery. It benefits bowel barrier function and further improves the recovery after surgery. Besides, earlier enteral feeding is less costly compared to parenteral nutrition, and easy to operate. A more case-based, prospective controlled clinical study should be organized in the future to further evaluate the usefulness of earlier enteral feeding in the patients with surgery., http://www.100md.com
单位：辽宁开原市第一医院
关键词：
中国临床营养杂志000154摘 要：目的总结术后早期(24～36小时)肠内营养应用的经验，疗效及并发症。 方法总结三年来我院实施5例术后早期肠内营养的方法、疗效及并发症。 结果5例术后早期肠内营养的病人疗效满意，病人营养状况改善，体重增加，原发病(2例高位肠痿，3例胰、十二指肠、脾等脏器损伤)均治愈。5例中仅一例出现恶心，予对症治疗后缓解，2例高位肠痿应用肠内营养4周痊愈出院。3例多发脏器损伤应用肠内营养7～10天，均于2周出院。无感染发生。 结论本组资料显示，术后早期应用肠内营养，既能改善病人营养状况，又可保护肠粘膜屏障作用，是防止术后感染的方法之一。
Analysis of the post-operative earlier enteral nutrition support in surgically-stressed patients
, http://www.100md.com
ZHANG Ge
(The First Hospital of)
Abstract：Objective It has been demonstrated that para-operative fasting often induce gastrointestinal mucosal atrophy, that, together with the surgically-stress effects, deteriorate the intestinal harrier structure and may further cause gut-origin infection. Parenteral nutrition has been widely employed in the patients undergone surgery or with trauma as a standard nutritional support in many hospitals. It can provide sufficient nutrients, including calories, nitrogen, and minerals for the daily and extra needs during the stress. However, numbers of investigations have proven that long term parenteral nutrition support has no effects on preventing intestinal mucosa atrophy, but indeed, consistently result in down-regulation of mucosal structure. It has been widely accepted in the clinic that enteral nutrition should be chosen as a priority mean, as to parenteral nutrition, to support the patients whenever they can tolerant. However, there are few reports concerning earlier use of enteral nutrition in post-operative patients. The purpose of this study was to evaluate the effects of postoperative earlier enteral nutrition support (24～36 hours) on the patients undergone major surgery. The cases with earlier enteral nutrition feeding during last three years were reviewed and the feeding method, the effectiveness, and the complications of earlier feeding were investigated. In five cases, with two of proximal small intestine fistula, three of pancreas, duodenal injury, the total effectiveness was satisfactory. All patients gained wight and the nutritional states were much improved. The initial disease of the patients with earlier feeding were all cured within the time periods which were significantly shorter than those who had ordinary post-operative feeding. Only one case among five had mild nausea during the feeding, and was settled after anti-nauseas medications. Two cases with proximal small intestine fistula were recovered in four weeks time. We thus conclude that earlier enteral feeding post-operatively is a safe and effective method for those who have major surgery. It benefits bowel barrier function and further improves the recovery after surgery. Besides, earlier enteral feeding is less costly compared to parenteral nutrition, and easy to operate. A more case-based, prospective controlled clinical study should be organized in the future to further evaluate the usefulness of earlier enteral feeding in the patients with surgery., http://www.100md.com