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急性出血坏死性胰腺炎术后早期实施肠内营养的临床研讨 被引量:23

CLINICAL STUDY ON EARLY POSTOPERATIVE ENTERAL NUTRITION IN PATIENTS WITH ACUTE HEMORRHAGIC NECROTIZING PANCREATITIS
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摘要 探讨急性出血坏死性胰腺炎( AHNP) 患者术后早期经空肠造瘘管实施肠内营养( EN) 的安全性、可行性及有效性。本组38 例患者分为术后3 ~4 天开始EN 的早期组和术后7 天开始EN 的后期组,均经空肠造瘘管持续滴注肠内营养液,并由肠外营养逐步过度到EN。测定2 组患者的耐受性指标( 血淀粉酶、血糖及肝功能) 、有效指标( 血浆白蛋白)并观察临床症状: 有无腹痛及腹部体征。结果: 耐受性指标2 组均在正常范围,而有效性指标提示早期组的血浆白蛋白值升高较快、低蛋白血症的纠正比后期组早,2 组均无腹痛等现象。提示AHNP 患者术后早期实施EN 是安全、可行和有效的,它能提高治愈率,在治疗AHNP 中起到重要的作用。 To evaluate the feasibility, safety and effectiveness of enteral nutrition (EN) via jejunostomy in the early postoperative period in patients with acute hemorrhagic necrotizing pancreatitis (AHNP), 38 patients were divided into the early group (start EN 3 or 4 days after operation) and the later group (start EN 7 days after operation). All patients received parenteral nutrition at first, then were transited to EN. The enteral nutrition liquid was transfused by continuous drip via jejunostomy in both groups. Levels of serum amylase, blood glucose, as well as the liver function were used as indices of tolerance. Symptoms and physical signs of abdominal pain as well as the level of serum albumin were used as the indices of effectieness. Patients tolerated the therapy well in both groups. Moreover, they enjoyed an earlier correction of hypoalbuminemia with more quickly improved serum albumin and no abdominal pain. Starting enteral nutrition in the early postoperative period is feasible, safe and efficacious for acute hemorrhagic necrotizing pancreatitis patients. It plays an important role in treating AHNP and improving curing rate.
作者 陈丽莉 朱捷
出处 《中国普外基础与临床杂志》 CAS 1999年第6期355-356,共2页 Chinese Journal of Bases and Clinics In General Surgery
关键词 急性 出血坏死性 胰腺炎 空肠造瘘 肠内营养 Acute hemorrhagic necrotizing pancreatitis Jejunostomy Enteral nutrition
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  • 1张延龄,实用外科学,1992年
  • 2顾寿年,解放军医学杂志,1984年,6卷,157页
  • 3M. G. Mythen,A. R. Webb. The role of gut mucosal hypoperfusion in the pathogenesis of post-operative organ dysfunction[J] 1994,Intensive Care Medicine(3):203~209

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