CAJ | 학술논문

目的总结十二指肠外瘘的营养治疗经验.方法对1999年1月至2009年12月间收治的32例十二指肠外瘘患者的临床资料进行回顾性分析.结果 32例患者平均接受35.6(8～82) d的营养支持疗法,其中8例接受全肠外营养支持(TPN),2例接受全肠内营养支持(TEN),22例接受肠外肠内联合营养支持(PN加EN).11例患者进行了肠液回输;28例予以谷氨酰胺强化;22例肠瘘初期加用了生长抑素.本组24例十二指肠外瘘患者经非手术治愈,自然愈合率为75.0%;8例接受手术,治愈6例,死亡2例(分别死于严重腹腔感染和多系统器官衰竭);共计30例患者痊愈出院.结论肠外肠内营养支持结合肠液回输、强化谷氨酰胺、生长抑素等措施,可促进十二指肠外瘘愈合.
목적 총결십이지장외루적영양치료경험.방법 대1999년1월지2009년12월간수치적32례십이지장외루환자적림상자료진행회고성분석.결과 32례환자평균접수35.6(8～82) d적영양지지요법,기중8례접수전장외영양지지(TPN),2례접수전장내영양지지(TEN),22례접수장외장내연합영양지지(PN가EN).11례환자진행료장액회수;28례여이곡안선알강화;22례장루초기가용료생장억소.본조24례십이지장외루환자경비수술치유,자연유합솔위75.0%;8례접수수술,치유6례,사망2례(분별사우엄중복강감염화다계통기관쇠갈);공계30례환자전유출원.결론 장외장내영양지지결합장액회수、강화곡안선알、생장억소등조시,가촉진십이지장외루유합.
Objective To summarize the experience in nutritional support for the management of duodenocutaneous fistula. Methods Data of 32 patients with duodenocutaneous fistula in Zhejiang provincial people′s hospital from January 1999 to December 2009 were analyzed retrospectively. Results The mean duration of nutritional support was 35.6 days (range, 8-82 days). Eight received total parenteral nutrition, 2 total enteral nutrition, and 22 parenteral nutrition combined with enteral nutrition respectively. Succus entericus reinfusion with enteral nutrition was used in 11 cases, glutamine-enriched nutritional support in 28 cases, somatostatin in 12 cases. In these patients, the healing rate was 75.0% after conservative treatment. In the 8 patients who underwent surgery, 6 were cured and 2 died (due to severe abdominal infection and multiple organ failure). A total of 30 patients had the fistulas cured and discharged. Conclusions Parenteral nutrition combined with enteral nutrition, succus entericus reinfusion combined with enteral nutrition, glutamine-enriched nutritional support and somatostatin are important factors for the healing of duodenocutaneous fistulas.