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不同途径早期营养支持对腹部手术后代谢反应的影响

Effect of early nutritional support by different routes on metabolic responses of postoprative surgical patiaents.

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【作者】 罗斌李国伟王文治

【Author】 Luo Bin; Li Guowi; Wang Wenzhi; (Department of Surgery, First Teaching Hospital, Beijing Medical University, Beijing 100034.)

【机构】 北京医科大学第一医院普通外科

【摘要】 17例腹部手术患者随机分为肠内(EN)和肠外(PN)营养二组。自术后第1天起,给予等氮等热卡的营养支持,连续8天。监测营养支持过程中体温、血浆蛋白、体重、氮平衡和与应激相关的激素变化。结果显示体温、血浆蛋白和体重变化两组间差异不明显,EN组术后第2天氮平衡明显优于PN组(3.2±2.6vs.-1.0±3.1g,P<0.05),EN组累积氮平衡虽亦优于PN组,但差异不显著。EN组术后第3天和第9天血胰高血糖素明显高于PN组(183±59vs.108±50和158±74vs.100±17pg/ml,P值均小于0.05),但皮质醇和胰岛素水平在两组间无差异。说明早期肠内营养和肠外营养相比,并不能减轻腹部手术后的应激反应和蛋白质分解代谢。

【Abstract】 Abstract Abdominal surgical patients were devided into enteral nutrition (EN, n = 10)and parenteral nutrition (PN, n =7) groups receiving isocaloric and isonitrogenous nutritional support from postoperative day 1 to day 8. The loss of body weight and the serum albumin level between the two groups did not reach statistical difference. The nitrogen balance of postoperative day 2 was better in EN groupthan PN group (3. 2± 2. 6 vs. -1. 3±3. 1g,P<0. 05),but there was no statistical difference in the cumulated nitrogen balance. There were not differences in temperature, plasma prealbumin, transferin, and catabolic hormone between the two groups. Early enteral nutrition did not attanuate metabolic response compared with parenteral nutrition in postoperative surgical patients.

【关键词】 肠饲胃肠外营养应激反应
  • 【分类号】R459.3
  • 【被引频次】2
  • 【下载频次】31
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