目的:探讨合理的营养支持方式对重症急性胰腺炎(SAP)患者营养状况及预后的影响。方法:将60例SAP患者随机分为全胃肠外营养支持(对照组)和肠内与肠外相结合营养支持(实验组)两组,对比营养支持前后两组患者的血红蛋白、总蛋白、血清白蛋白、氮平衡、血脂等生化指标,每天观察相关并发症情况。结果:实验组血清白蛋白、总蛋白、血红蛋白、氮平衡方面明显优于对照组(Plt;0.05),且并发症少。结论:肠内与肠外结合的营养支持方式可以改善SAP患者的营养状况,对SAP患者治疗有积极的作用。
ObjectiveTo explore clinical effect of enteral nutrition (EN) through nasojejunal tube in severe acute pancreatitis (SAP).MethodsThe clinical and pathological data of 76 patients with SAP who met the inclusion criteria and treated in the Third People’s Hospital of Henan Province from June 2015 to December 2018 were retrospectively collected. According to the nutritional support therapy adopted in the course of treatment, the patients were divided into an EN group (n=44) and a parenteral nutrition group (PN group, n=32), the patients in the EN group were given the EN through the nasojejunal tube and the patients in the PN group were given the routine PN. The APACHE Ⅱ and SOFA scores, nutritional status, and immune function were observed before the treatment and on week 2 after the treatment in the two groups.ResultsThere were no significant differences in the general data of the gender, age, body mass index, etc. between the two groups (P>0.050). ① The score of APACHEⅡ or SOFA score on week 2 after the treatment in both groups was significantly lower than that before the treatment (P<0.050), which in the EN group was significantly lower than that in the PN group on week 2 after the treatment (P<0.050). ② The levels of albumin and prealbumin were increased significantly and the hemoglobin level was decreased (P<0.050) on week 2 after the treatment as compared with those before the treatment in the two groups (P<0.050), which in the EN group were significantly higher than those in the PN group on week 2 after the treatment (P<0.050). ③ The CD4, CD8, and CD4/CD8 and IgG, IgM, and IgA on week 2 after the treatment were significantly lower than those before the treatment in these two groups (P<0.050), which in the EN group were significantly higher than those in the PN group on week 2 after the treatment (P<0.050). ④ The levels of endotoxin, D-lactic acid, diamine oxidase, and serum high mobility group protein B1 on week 2 after the treatment were significantly lower than those before the treatment in the two groups (P<0.050), and which in the EN group were significantly lower than those of the PN group on week 2 after the treatment (P<0.050). ⑤ The complications rate in the EN group was significantly lower than that in the PN group [20.45% (9/44) versus 53.13% (17/32), χ2=8.786, P=0.003].ConclusionEN through nasojejunal tube has a good effect on patients with SAP, which is helpful to improve their immune and nutritional status.
Objective To explore the protective effect of early enteral nutrition on intestinal mucosa barrier in patients with esophageal carcinoma after operation. Methods Fifty six patients with esophageal carcinoma whose weight decreased more than 20% before operation in three months were divided into enteral nutrition group ( n =30) and parenteral nutrition group ( n =26). Plasma concentration of lipopolysaccharide(LPS), tumor necrosis factor (TNF), gastrin, glutamine, and ratio of lactulose and mannitol (L/M) were measured on the 1st, 4th, 8th day after operation respectively. Results Weight loss and infectious complication in enteral nutrition group were less than those in parenteral nutrition group after operation ( P lt;0.01, 0.05). On the 4th and 8th day after operation,the level of LPS,TNF, and L/M were lower in enteral nutrition group than those in parenteral nutrition group ( P lt;0 01), the values of gastrin and glutamine were higher in enteral nutrition group than those in parente...更多ral nutrition group ( P lt;0 01). Conclusion Enteral nutrition can protect the intestinal mucosa barrier and decrease infectious complication after operation.
目的 探讨结直肠癌术后早期肠内营养的可行性、安全性及临床疗效。方法 将50例结直肠癌术后患者随机分为肠内营养(EN)治疗组和肠外营养(PN)治疗组,均给予营养支持治疗至术后第7 d。 测定手术前、后的淋巴细胞计数(LC)、血清总蛋白(TP)、白蛋白(Alb)、前白蛋白(Pa)、转铁蛋白(Tf)、丙氨酸氨基转移酶(ALT)及总胆红素（TB）指标的变化，同时观察胃肠功能恢复时间。结果 EN组的LC、TP、Alb、Pa、Tf、ALT与PN组差异无统计学意义（P＞0.05），TB低于PN组（t＝2.45，P＜0.05）； EN组胃肠功能恢复时间早于PN组（t＝8.60，P＜0.001）。结论 结直肠癌术后早期营养支持应首选EN。
Objective To investigate the effects of immune—enhancing enteral nutritioin therapy on the inflammatory reaction and immune function in the rats of ventilation-induced lung injury．Methods Fourty rats were divided into four groups(EN1、EN2、SEN1、SEN2，n=10)．All groups were performed mechanic ventilation and fed isocaloric enteral nutrition．EN1 group：tidal Volume(VT) =8 mL／kg，traditional enteral nutrition；EN2 group：VT=40 mL／kg，traditional enteral nutrition；SEN1 group：VT：8 mL／kg，immune-enhancing enteral immunonutrition；SEN2 group：VT=40 mL／kg，immune-enhancing enteral immunonutrition．Lymphocyte subsets，TNF-α，IL-6 and contents of arachidonic acid(AA)were determined at different time point(0，4，24，72 h after ventilation)．Results The levels of CD3+，CD4+，CD4+／CD8+ in SEN2 group were lower(Plt;0.05)than in EN1，EN2 and SEN1 group after 24，72 h of ventilation．The serum concentrations of TNF-α，IL-6 and AA were significantly lower in EN2 than in other three groups(P lt;0.05)．Conclusion Immune-enhancing enteral nutrition feeding prior to machanie ventilatioin can alleriate the damage of immunological function and reduce infl ammotory responses
ObjectiveTo evaluate the safety and efficacy of preoperation administration of enteral nutrition enriched ω-3 fatty acids for gastric cancer patients. MethodsA single center randomized controlled clinical trial was performed in 60 cases of gastric cancer in West China Hospital during January 2014 to June 2014, and cases were equally randomized divided into treatment group and control group. Cases of treatment group were given enteral nutrition enriched ω-3 fatty acids which was manufactured by Fresenius Kabi Deutschland GmbH for 5 consecutive days before operation, and cases of control group were given an isocaloric and isonitrogenous homogenized diet for 5 consecutive days before operation. The laboratory indexes of nutritional status and imflammatory factors were observed and compared between 2 groups on admission, preoperative day 1, postoperative day 3, and postoperative day 5. Liver and kidney function indexes which as the safety indexes were detected on admission and preoperative day 1. Vomiting, diarrhea, and infectious complications were recorded in addition. ResultsOn 3 days after operation, levels of interleukin-6 (IL-6) and α-acid glycoprotein (AAG) of treatment group were both lower than those of control group (P<0.05); on 5 days after operation, levels of C-reactive protein (CRP) of treatment group was lower than that of control group too (P<0.05); but at other time points, there were no significant differences in any index between the 2 groups (P>0.05). During the period of enteral nutrition, only 1 case suffered from bloating and 1 case suffered from diarrhea, both in treatment group, and the incidence of adverse reactions didn't differed between treatment group[6.7% (2/30)]and control group[0 (0/30)], P>0.05. Moreover, there were no significant differences between treatment group and control group in incidences of wound infection[3.3% (1/30) vs. 10.0% (3/30)], abdominal infection[0 (0/30) vs. 3.3% (1/30)], urinary infection[0 (0/30) vs. 3.3% (1/30)], and pulmonary infection[0 (0/30) vs. 6.7% (2/30)], but the total incidence of complication was lower in treatment group than that of control group[3.3% (1/30) vs. 23.3% (7/30)], P=0.026. ConclusionEnteral nutrition enriched ω-3 fatty acids can reduce the rate of infection-related complication for patients with gastric cancer, and has a sense of safety.
【摘要】目的探讨在数字减影 (DSA)透视下,经过鼻腔将胃管、空肠营养管联合置入及其临床应用的范围和价值。方法选择2007年8月23日2009年10月22日期间35例需要行肠内营养的患者,在DSA透视下经鼻腔将胃管以及预先套入的空肠营养管联合置入,置管成功后分别造影,显示胃管位于胃内,而空肠营养管末端位于空肠内。结果35例患者成功置管。置管时间为49～186 min,平均108 min。置管中及置管后未发生严重并发症。置管后营养管在位良好,喂养过程顺利。结论DSA透视下经鼻胃管、空肠营养管联合置入是一种安全、经济、有效的肠内营养途径,同时解决了胃液引流问题,具有一定的临床应用价值。
Abstract: Objective To determine the effects of early enteral nutrition (EEN) on postoperative recovery in elderly patients with esophageal cancer. Methods We included 100 elderly patients with esophageal cancer who were admitted at the PLA 100 Hospital between January 2006 and April 2010, and whose diagnoses were confirmed by pathological examination. The patients were divided into an early enteral nutrition (EEN) group and a parenteral nutrition (PN) group, with 50 patients in each group. There were 32 males and 18 females with an average age of 72 years in the EEN group. There were 30 males and 20 females with an average age of 69 years in the PN group. We analyzed the effect of the nutrition administration method on bowel function recovery, hospital stay, complication rate, and nutritional status one week after surgery. Results The anal exhaust time (45.3±12.7 h vs. 73.6±11.7 h), time until anal defecation (80.5 h±15.6 h vs. 140.1±13.2 h), and hospital stay (13.0±1.8 d vs. 15.2±3.3 d) in the EEN group were all shorter than those in the PN group (Plt;0.05). The rates of lung infection, anastomotic leakage, and cardiac complications in the EEN group were significantly lower than those of the PN group (Plt;0.05). One week after the operation, the serum albumin (ALB), peripheral blood lymphocytes, transferrin, and 24 h urea nitrogen (BUN) in the EEN group were higher than those in the PN group (Plt;0.05). Conclusion Compared with parenteral nutrition, enteral nutrition can promote metabolic function in elderly patients after recovery, reduce morbidity, and promote recovery.
Objective To study the current clinical application and advancement of microbioecological preparation. Methods Literatures about microbioecological preparation published in China and abroad were collected and reviewed. Results The microbioecological preparation has been widely used at present. It is used to rebuild a balanced microbial population in human body, particularly in intestinal, to promote the stability of internal environment, control dysbacteriosis and to treat a variety of gastrointestinal diseases associated with ectopic microbial population. Conclusion Although microbioecological preparation has been widely used in clinical settings, its effect yet should be further supported and evaluated both by large sample research in randomized double-blind control trails and evidence-based medicine.