早期肠内营养联合益生菌在胃肠道创伤患者术后的应用.doc

早期肠内营养联合益生菌在胃肠道创伤患者术后的应用 童锋 应佑华 郭松永 赵伟 潘海华 【摘要】目的 探讨早期肠内营养（EEN）联合益生菌在胃肠道创伤术后患者中的应用价值。方法 将43例胃肠道创伤术后患者随机分为肠外营养（PN）和EEN两组，PN组采用肠外营养，EEN组采用早期肠内营养联合益生菌治疗。术后第1天和第7天分别进行急性生理和慢性健康状况Ⅱ评分(APACHEⅡ评分)，测定血清白蛋白（ALB）、前白蛋白（PA）、转铁蛋白（TF）、C反应蛋白（CRP）、前降钙素（PCT），经留置尿管测定膀胱内压观察腹内压变化，比较术后首次肛门排气、排便时间，感染性并发症，术后住院时间。结果 两组患者术后第7天的ALB,PA,TF均比术后第1天明显升高（均P＜0.05），而两组间的差异无统计学意义。EEN组的APACHEⅡ评分，PCT,CRP降幅均显著高于PN组（均P＜0.05），术后首次肛门排气、排便时间及住院时间明显短于PN组（均P＜0.05）。结论 EEN联合益生菌可显著改善胃肠道创伤患者的营养状况，抑制过度炎症反应，保护和促进肠功能恢复，缩短住院时间。 【关键词】胃肠道创伤；早期肠内营养；益生菌；术后 The use early enteral nutrition combined with probiotics in postoperative patients with gastrointestinal trauma. TONG Feng,YING You-hua,GUO Xong-yong,ZHAO Wei,PAN Hai-hua.Department of General Surgery,The People,s Hospital of Lanxi,Zhejiang321100,China Corresponding author:TONG Feng E-mail:tongfeng1073@【abstract】Objective To explore the value of early enteral nutrition (EEN) combined with probiotics in postoperative patients with gastrointestinal trauma. Methods 43 patients with gastrointestinal trauma were randomly divided into parenteral nutrition (PN) group (n=21) and EEN group (n=22).The PN group received early enteral nutrition combined with probiotics. Albumin(ALB),prealbumin(PA),transferring(TF), C-reactive protein, procalcitonin(PCT),the bladder pressure were determined at days 1,7 after operation, the APACHE Ⅱ score ,the time to first defecation ,the mean postoperative length of hospital stay were observed and compare between two groups.Results In all patients,the levels of ALB,PA,TF on the 7 days after operation were obviously elevated than those at 1 days after operation (P＜0.05).there was no singnificant different between two groups （P＞0.05）.The APACHEⅡ score and CRP,PCT were significantly reduced than those in PN group (P＜0.05). The time to first defecation ,the mean postoperative length of hospital stay were significantly earlier in EEN group than those in PN group (P＜0.05). Conclusion The early enteral n