摘要
目的探讨肝移植术后患者营养支持的作用和方法选择。方法43例肝移植术后患者随机分为完全胃肠外营养(totalparenteralnutrition)为对照组和早期肠内营养(earlyenteralnutrition)为观察组,TPN组经锁骨上静脉进行,EN+PN组术后24h内经鼻肠管输注肠内营养制剂瑞素,不足部分辅以肠外营养,共7天。结果EN+PN组完成肠内营养计划,未出现不良反应。两组术后第1天营养指标、肝功能指标组间比较无差异(P>0.05),第8天营养状况及肝功能恢复均优于第1天,EN+PN组恢复更有优势,TPN组、EN+PN组肛门恢复排气时间分别为(4.1±0.4)天、(3.0±0.7)天(P<0.01),术后住院天数各为(29±5)天、(23±4)天(P<0.01),营养治疗费用EN+PN组低于TPN组(P<0.01)。与感染有关的并发症TPN组13例,EN+PN组6例。结论肝移植术后早期(24h内)提供肠内营养是安全可行的,与完全胃肠外营养相比,早期肠内营养可有效改善患者的营养状况,促进移植肝功能恢复,降低营养费用,缩短了术后住院天数,减少了感染发生率。
Objective To investigate the efficacy and the selection of methods of nutritional support in liver transplant patients. Methods Forty-three cases of liver transplant patients were randomly assigned to total parenteral nutrition (TPN) group and early enteral nutrition (EN+PN) group, patients in TPN group were administered via a subclavian route, and patients in EN+PN group were administered enteral nutriment of Fresubin via a gastric tube, with assisted with PN for 7 days in all. Results No side effects occurred during the enteral nutritional program in the EN+PN group. Both of the two groups had no difference in nutritional and liver functional parameter on the first day (p>0.05), which were better on the eighth day, and the rehabilitation of the EN+PN group were preferable. Recovery times of enteral function of the TPN and the EN+PN group were (4.1±0.4) days and (3.0±0.7) days (p<0.01), the hospital days were (29±5) days and (23±4) days (p<0.01), and the expenses of EN+PN group were lower. 13 cases infectious complications occurred in TPN group and 6 cases in EN+PN group. Conclusions Enteral nutrition is safe and feasible in 24 hours after liver transplantation. Compared with the TPN, early EN (EEN) is preferable to improve the nutritional status, promote the resume of transplant liver function, decrease the nutritional expenses, shorten the postoperative hospitalization and reduce the incidence of infection.
出处
《现代护理》
2005年第8期613-615,共3页
Modern Nursing
关键词
肝移植
营养
TPN
EN+PN
观察及护理
Liver transplantation Nutrition TPN
EN+PN Observation and nursing
