腹部手术患者术后早期肠外营养支持的临床研究

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1、腹部手术患者术后早期肠外营养支持的临床研究作者：李云峰，王亚荣,张晨光单位：女阳矿物局总医院普外科，河南女阳455000；新乡医学院医学检验系，河南新乡453003【摘要】目的研究腹部手术患者术后早期肠外营养(PN)支持前后血液营养指标的变化，并探讨其临床意义。方法38例腹部手术患者术后分为营养组(n=20)和对照组(n=18),营养组于术后24h内开始营养治疗，对照组不进行营养治疗，观察2组患者术前及术后第1天、第10天血液清蛋白(ALB)、前清蛋白(PA)、转铁蛋白(TRF)、免疫球蛋口(IgA、I*｝、IgM)、预后营养指数(PNI)值的变化。结果(1)2组术前和术后第1天各指标比鮫

2、均无显著差异(P>0.05)；(2)术后第1天2组ALB、PA、TRF、IgA、IgM均显著低于术前(P<0.05),IgGxPNI有降低趋势(P>0.05)；(3)柿第10天营养组ALB、PA、TRF、IgA、IgG>IgM、PNI均恢复到术前水平(P>0.05),乂照组ALB、PA、TRJF、IgA、IgG、IgM、PNI降低更为严重(P<0.05,P<0.01)；营养组ALB、PA、TRF、IgA、IgG、IgM、PNI均明显高于对照组(P<0.05,P<0.01)o纟鉅术后早期肠外营养支持能改善腹部手术患者术后营养状况及机体免疫功能，

3、有助于促进术后患者康复。【关键词】腹部；手术；肠外营养ClinicalstudyonearlypostoperativeparenteralalimentationinpatientswithabdominalsurgeryLIYun-feng,WANGYa-rong,ZHANGChen-guang1.DepartmentofOrdinarySurgery,theGeneralHospitalofAnyangMineralBureau,Anyang55000,China;2.DepartmentofInspection,XinxiangMedicalCollege,Xinxiang4530

4、03,ChinaAbstract:ObjectiveTostudytheindexchangesandclinicalsignificanceofhemotrophicnutritionindexesbeforeandaftertheearlypostoperativeparenteralalimentationofpatientswithabdominalsurgery.MethodsThirtyeightcasesofabdominaloperationwererandomlydividedintotwogiwps,namelyPNgroup(20cases)andcontrolgro

5、up(18cases),thenutritionaltherapywasstalled24hoursaftertheoperation.Albumin(ALB),prealbumin(PA),transferring(TRF),totallymphocytecount(TLC)andimmunoglobulin(IgAJgQIgM)ofthe38patientsweredetectedandcomparedbetweenthetwogroupsduringpre-operationandpost-operation.Results(l)Therewasnosignificantdiffer

6、enceinallindexesbeforeoperationandafteroperationonthefirstdaybetweentwogroups;(2)Withearlypostoperativeparenteralnutrition^alldetectedindexesonPNgrouprecoveredpreoperativelevel,andtherewaslowerlevelinALB,PA,TRFJgM,PNIonthe10thdaythanonthefirstday;(3)Whilealldetectedindexesincontrolgroupdecreasedmo

7、regreatlyonthe10thday;(4)Comparisonbetweenthetwogroups,alldetectedindexesweresignificantlylowerinthecontrolgroupthaninthePNgrouponthe1Othday,andtherewasobviousdifferencesonthefirstdayandonthe10thday.respectively.