中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (07): 578-580.

• 论著 • 上一篇    下一篇

早期肠内肠外营养支持对肝硬化肝切除术后影响的研究

赖佳明a，梁力建a，华赟鹏a，方 仕b，黄 力a，王恕同a，彭宝岗a   

  1. 中山大学附属第一医院 a.肝胆外科 b.营养科，广东广州 510080
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-07-08 发布日期:2009-07-08

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-07-08 Published:2009-07-08

PDF

摘要：

目的 探讨早期肠内营养和肠外营养对肝硬化肝部分切除术后病人的影响。 方法 2007-2008年选择中山大学附属第一医院肝胆外科行肝部分切除手术且术后病理证实有肝硬化的病人35例，其中行早期肠内营养（EEN组）16例，肠外营养（PN组）19例。两组均于术后24h开始给予营养支持，共7d。观察术前、术后1d及术后8d病人一般情况、肝脏功能、临床营养、临床并发症等指标的变化。 结果 两组病人在平均住院时间、术前后肝功能、临床营养指标变化的差异无统计学意义；EEN组术后8d前白蛋白和白蛋白已恢复到术前水平，与营养支持相关的并发症发生率高于PN组，但较PN组轻。EEN组术后胃肠蠕动功能恢复较快，平均营养费用也明显低于PN组。结论 肝硬化肝部分切除术后进行早期肠内营养是安全、有效、合理的营养支持方式。

关键词: 肝硬化, 肝切除术, 肠内营养, 肠外营养

Abstract:

Early postoperative enteral nutrition compared with parenteral nutrition in patients with liver cirrhosis after hepatectomy LAI Jia-ming*, LIANG Li-jian,HUA Yu-peng, et al. *Department of Hepatobiliar Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China Corresponding author: LIANG Li-jian, E-mail：LiangLJ@medmail.com.cn Abstract Objective To evaluate the impact of early enteral nutrition over parenteral nutrition in patients with liver cirrhosis after hepatectomy. Methods Thrity -five patients with liver cirrhosis undergoing liver resection were study: EEN group, received early enteral nutrition (n=16); PN group, received parenteral nutrition (n=19). The two groups were received nutritional formulas with isocaloric and isonitrogenous 24 hours after operation, and they were ended at postoperative day 7. The general conditions, liver function tests, clinic complications, clinic nutritional variables on three time point that included preoperative phase, postoperative day 1 (POD 1) and postoperative day 8 (POD8) were observed respectively. Results No significant difference was found in length of hospital stay, liver function,and clinic nutritional variables between the two groups. In the EEN group, the serum prealbumin and albumin level neared the preoperative level on POD8. Nutritional complication rate of EEN group was increased signiflcanly ，but mild than the PN group respectively .The time of gut function recover was shorter than PN group.The costs of nutritional drugs showed a signiflcant decrease in the EEN group. Conclusion Early enteral nutrition is safe, rational and effective in patients with liver cirrhosis after hepatectomy.

Key words: liver cirrhosis, hepatectomy, enteral nutrition, parenteral nutrition