期刊文献+

婴幼儿先天性胆总管囊肿术后早期肠内营养与肠外营养 被引量:5

Comparison of postoperative early enteral nutrition and parenteral nutrition in infants with congenitalcholedochal cyst
收藏 分享 导出
摘要 目的探讨婴幼儿先天性胆总管囊肿术后早期肠内营养(EEN)的实施方法及临床效果。方法分析2014年1月至2015年12月在南京医科大学附属南京儿童医院普外科行胆总管囊肿切除+胆道重建术(Roux—en—Y吻合术)患儿的临床资料,采用随机对照试验设计,分为研究组(EEN组)和对照组[全胃肠外营养(TPN)组],研究组术后48h起予以肠内营养;对照组术后常规予以TPN。比较两组患儿入院第1天和术后第7天体质量、前白蛋白、视黄醇结合蛋白、血红蛋白、免疫球蛋白及淋巴细胞计数;比较两组术后首次排便时间、平均拔胃管时间、胃肠减压引流总量以及术后并发症等方面的差异。结果共有68例患儿完成了临床观察。两组术前体质量、身高、疾病分布、营养指标相比差异无统计学意义;术后EEN组的首次排便时间[(69.20±9.37)h比(84.73±5.12)hi、平均拔胃管时间[(110.48±5.47)h比(134.90±6.97)h]及胃肠减压引流总量[(202.31±32.89)ml比(258.70±25.52)m1]较TPN组显著提前或减少(均P〈0.001);术后第7天EEN组的体质量和血红蛋白与TPN组相比,差异无统计学意义;前白蛋白及视黄醇结合蛋白[(0.21±0.06)g/L比(0.14±0.05)g/L、(35.98±6.13)mg/L比(28.41±6.09)mg/L)明显高于TPN组(均P〈0.001);术后第7天免疫指标淋巴细胞计数及免疫球蛋白两组相比差异有统计学意义[(1.33±0.05)×10^9/L比(0.69±0.06)×10^9/L、(0.67±0.09)g/L比(0.49±0.10)g/L,均P〈0.001];两组术后并发症相比差异无统计学意义(均P〉0.05)。术后平均随访3—24个月,患儿术后恢复满意,生长发育良好。结论婴幼儿先天性胆总管囊肿术后EEN治疗可行、安全、有效,有助于患儿胃肠道功能恢复,改善营养及免疫状况,利于患儿术后恢复。 Objective To evaluate the application and clinical effectiveness of early enteral nutrition (EEN) used after operation in infants with congenital choledochal cyst (CCC). Methods This randomised controlled trial enrolled 68 patients receiving choledochal cyst excision plus biliary reconstruction ( Roux-en-Y anastomosis) for CCC in Department of General Surgery of Affiliated Nanjing Children's Hospital of Nanjing Medical University between January 2014 and December 2015. The infants were randomly divided into EEN group ( n = 34) and total parenteral nutrition (TPN) group (n = 34). The EEN group received enteral nutrition 48 hours after surgery, while the TPN group was given conventional parenteral nutrition after surgery. The body mass, prealbumin, retinol binding protein, hemoglobin, immunoglobulin and lymphocyte count were com- pared between the two groups on day 1 after admission and day 7 after operation. The time of first defecation,the time of gastric tube removal, the amount of gastrointestinal drainage, and the incidence of complications af- ter surgery were also compared between the two groups. Results A total of 68 infants completed the clinical observation. There were no significant differences in the preoperative body mass, height, disease distribution, and nutritional indexes between the two groups. Compared with the TPN group, the time of first defecation [ (69. 20± 9.37) hours vs. ( 84.73 ± 5.12) hours ], the time of gastric tuberemoval [ ( 110.48± 5.47 ) hours vs. ( 134. 90 ± 6. 97) hours ], and the amount of gastrointestinal drainage [ (202. 31± 32. 89) ml vs. (258.70±25.52) ml] were all shorter/lower in the EEN group ( all P 〈0. 001 ) ; the body mass and hemoglobinlevel on day 7 after surgery did not show statistically significant difference between the two groups. The serum level of prealbumin [ ( 0. 21 ±0. 06 ) g/L vs. ( 0. 14 ± 0. 05 ) g/L ], retinol binding protein [ (35.98±6. 13) mg/Lvs. (28.41 ±6.09) mg/L], lym
作者 盛玉 李梅 姜斌 黄磊 杜宝峰 周峻 杨颖 李黎 张爱贤 Sheng Yu, Li Mei, Jiang Bin, Huang Lei, Du Baofeng, Zhou Jun, Yang Ying, Li Li, Zhang Aixian.( Department of General Surgery, the Affiliated Nanjing Children's Hospital of Nanjing Medical University, Nanjing 210008, China )
出处 《中华临床营养杂志》 CAS CSCD 2016年第4期209-214,共6页 Chinese Journal of Clinical Nutrition
基金 南京市卫生局科研项目(YKK14114)
关键词 胆总管囊肿 肠道营养 胃肠外营养 婴幼儿 Choledochal cyst Enteral nutrition Parenteral nutrition Infant
作者简介 通信作者:李梅,E-mail:limeilimei6868@126.com
  • 相关文献

参考文献14

  • 1赵洁,李银侠,杨美华.小儿先天性胆总管囊肿的治疗与护理进展[J].实用临床医药杂志,2013,17(12):168-170. 被引量:4
  • 2Huang L, Zhang H, Liu G, et al. The effect of laparoscopic exci- sion vs open excision in children with choledochal cyst: a midterm follow-up study [ J ]. J Pediatr Surg, 2011, 46 (4) : 662- 665. DOI: 10. 1016/j. jpedsurg. 2010.10. 012. 被引量:1
  • 3Diao M, Li L, Cheng W. Laparoscopic versus Open Roux-en-Y hepatojejunostomy for children with choledechal cysts: intermedi- ate-term follow-up results [ J ]. Surg Endosc, 2011,25 ( 5 ) : 1567- 1573. DOI: 10. 1007/s00464-010-1435-x. 被引量:1
  • 4林海伟(综述),李龙(审校).婴幼儿胆汁淤积性肝病的外科治疗进展[J].中华小儿外科杂志,2012,33(4):304-306. 被引量:4
  • 5龚四堂.肠内营养技术在儿科中的应用[J].中华实用儿科临床杂志,2014,29(7):481-483. 被引量:10
  • 6Osland E,Yunus R, Khan S, et al. Early enteral nutrition with in 24 h of intestinal surgery versus later commencement of feeding: a systematic review and metaanalysis[ J]. J Gastrointest Surg,2009, 13(6) :1163-1165. DOI: 10. 1007/s11605-009-0846-2. 被引量:1
  • 7卞晓洁,王萌,葛卫红,管文贤.消化道重建术后的肠内营养支持治疗进展[J].中国肿瘤临床,2014,41(18):1150-1153. 被引量:3
  • 8Weimann A, Braga M, Harsanyi L, et al. ESPEN Guidelines on Enteral Nutrition: Surgery including organ transplantation [ J ]. Clin Nutr, 2006, 25(2):224-244. 被引量:1
  • 9Codner PA. Enteral nutrition in the critically ill patient[J]. Surg Clin North Am, 2012, 92(6) :1485-1501. DOI: 10. 1016/j. suc. 2012.08. 005. 被引量:1
  • 10Seherubl H. Rectal earcinoids are on the rise: early detection by screening endoscopy [ J ]. Endoscopy, 2009, 41 ( 2 ) : 162- 165. DOI: 10. 1055/s-0028-1119456. 被引量:1

二级参考文献98

共引文献20

同被引文献37

引证文献5

二级引证文献5

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈