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营养支持方式对肠破裂修补术后合并腹腔感染患者的影响
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R459.3

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Effects of nutritional support method for patients with abdominal infection after intestinal rupture repair
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    摘要:

    目的 探讨营养支持方式对肠破裂修补术后合并腹腔感染患者血浆蛋白、肝肾功能及血清内毒素、二胺氧化酶水平的影响。方法 按照随机数字表法将百色市人民医院 2018 年 8 月至 2020 年 12 月收治的 65 例肠破裂修补术后合并腹腔感染患者分为对照组(32例,给予肠内营养)和试验组(33 例,给予肠外营养联合肠内营养),两组患者均进行连续 5 d 的营养支持治疗。对比两组患者治疗前后血浆蛋白、肝肾功能指标、血清内毒素、二胺氧化酶及胃肠不耐受情况。结果 治疗后两组患者总蛋白、前白蛋白、白蛋白水平均较治疗前显著上升,且试验组均显著高于对照组(均 P < 0.05);治疗后两组患者血肌酐、天门冬氨酸氨基转移酶、胱抑素 C 水平均较治疗前显著下降(均P < 0.05),但组间各指标比较,差异均无统计学意义(均P > 0.05);治疗后两组患者血清二胺氧化酶、内毒素水平与治疗前比均显著下降,且试验组显著低于对照组(均P < 0.05);两组患者呕吐、恶心、胃胀、胃潴留发生率比较,差异均无统计学意义(均P > 0.05)。结论 相较于单独肠内营养,肠内营养联合肠外营养可通过提高血浆蛋白水平,改善肠破裂修补术后合并腹腔感染患者营养状态,有助于维持肠黏膜结构和功能的完整,且对肝肾功能指标影响较小,安全性良好。

    Abstract:

    Objective To investigate the effects of nutritional support method on plasma protein, liver and kidney function, serum endotoxin and diamine oxidase levels of patients with abdominal infection after intestinal rupture repair. Methods 65 cases patients with abdominal infection after intestinal rupture repair admitted to People's Hospital of Baise from August 2018 to December 2020 were divided into the control group (32 cases, received enteral nutrition) and the experimental group (33 cases, received parenteral nutrition combined with enteral nutrition) according to the random number table method,patients in the two groups received continuous 5 d nutritional support treatment. The plasma protein, liver and kidney function indexes, serum endotoxin, diamine oxidase and gastrointestinal intolerance of patients in the two groups before and after treatment were compared. Results Compared with before treatment, the levels of total protein, prealbumin and albumin of patients in the two groups significantly increased after treatment, and those in the experimental group were significantly higher than those in the control group (all P < 0.05);the levels of serum creatinine, aspartate aminotransferase and cystatin C of patients in the two groups after treatment significantly decreased compared with before treatment (all P < 0.05), but there were no statistical significance in all indexes between the two groups (all P > 0.05); after treatment, the levels of serum diamine oxidase and endotoxin of patients in the two groups significantly decreased compared with before treatment, and the experimental group was significantly lower than the control group (all P < 0.05); there were no significant difference in the incidence of vomiting, nausea, stomach distension and gastric retention between the two groups (all P > 0.05). Conclusion Compared with enteral nutrition alone, enteral nutrition combined with parenteral nutrition can improve the nutritional status of patients with abdominal infection after intestinal rupture repair by increasing the plasma protein level, which is helpful to maintain the integrity of intestinal mucosal structure and function, and has little impact on liver and kidney function indexes, and which has good security

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  • 在线发布日期: 2022-09-06
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