中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2010年
3期
162-166
,共5页
陈鄢津%杨强%赵卫川%周振理
陳鄢津%楊彊%趙衛川%週振理
진언진%양강%조위천%주진리
老年%肠梗阻%肠内营养
老年%腸梗阻%腸內營養
노년%장경조%장내영양
Elderly%Intestinal obstruction%Enteral nutrition
目的 对具有营养风险的非血运障碍的老年肠梗阻患者,在胃肠道有效低位减压基础上分别给予肠外及肠内营养支持,探讨肠内营养的安全性.方法 对老年肠梗阻患者采用内镜与X线辅助的肠梗阻导管的快速放置,进行肠道有效低位减压,改善肠道状况,恢复肠道功能,在此基础上按照给予肠外营养加肠内营养和仅给予肠外营养分组,分别观察患者临床症状的改善及肠内营养应用过程中并发症的发生,并比较两组的影像学及血常规、生化等指标变化.结果 平均(24.83±7.95)min可完成肠梗阻导管放置.65.0%的患者1～2 h内腹胀、腹痛情况明显缓解,27.5%患者在48 h内症状完全缓解.研究组开始肠内营养时间为导管放置后(25.25±8.17)h,多数患者可耐受肠内营养.两组患者入院时各项检测指标差异无统计学意义.入院时两组前白蛋白均值低于正常,但1周后两组均达到正常值范围,组内比较差异具有统计学意义(P<0.05),但差值的组间比较差异无统计学意义;两组患者入院时三酰甘油均值高于正常,治疗后研究组降至正常,但差值的组问比较差异无统计学意义.入院1周后再次比较两组各项检测指标,差异亦均无统计学意义.结论 在胃肠道有效低位减压条件下,老年肠梗阻患者给予肠内营养是安全的.
目的 對具有營養風險的非血運障礙的老年腸梗阻患者,在胃腸道有效低位減壓基礎上分彆給予腸外及腸內營養支持,探討腸內營養的安全性.方法 對老年腸梗阻患者採用內鏡與X線輔助的腸梗阻導管的快速放置,進行腸道有效低位減壓,改善腸道狀況,恢複腸道功能,在此基礎上按照給予腸外營養加腸內營養和僅給予腸外營養分組,分彆觀察患者臨床癥狀的改善及腸內營養應用過程中併髮癥的髮生,併比較兩組的影像學及血常規、生化等指標變化.結果 平均(24.83±7.95)min可完成腸梗阻導管放置.65.0%的患者1～2 h內腹脹、腹痛情況明顯緩解,27.5%患者在48 h內癥狀完全緩解.研究組開始腸內營養時間為導管放置後(25.25±8.17)h,多數患者可耐受腸內營養.兩組患者入院時各項檢測指標差異無統計學意義.入院時兩組前白蛋白均值低于正常,但1週後兩組均達到正常值範圍,組內比較差異具有統計學意義(P<0.05),但差值的組間比較差異無統計學意義;兩組患者入院時三酰甘油均值高于正常,治療後研究組降至正常,但差值的組問比較差異無統計學意義.入院1週後再次比較兩組各項檢測指標,差異亦均無統計學意義.結論 在胃腸道有效低位減壓條件下,老年腸梗阻患者給予腸內營養是安全的.
목적 대구유영양풍험적비혈운장애적노년장경조환자,재위장도유효저위감압기출상분별급여장외급장내영양지지,탐토장내영양적안전성.방법 대노년장경조환자채용내경여X선보조적장경조도관적쾌속방치,진행장도유효저위감압,개선장도상황,회복장도공능,재차기출상안조급여장외영양가장내영양화부급여장외영양분조,분별관찰환자림상증상적개선급장내영양응용과정중병발증적발생,병비교량조적영상학급혈상규、생화등지표변화.결과 평균(24.83±7.95)min가완성장경조도관방치.65.0%적환자1～2 h내복창、복통정황명현완해,27.5%환자재48 h내증상완전완해.연구조개시장내영양시간위도관방치후(25.25±8.17)h,다수환자가내수장내영양.량조환자입원시각항검측지표차이무통계학의의.입원시량조전백단백균치저우정상,단1주후량조균체도정상치범위,조내비교차이구유통계학의의(P<0.05),단차치적조간비교차이무통계학의의;량조환자입원시삼선감유균치고우정상,치료후연구조강지정상,단차치적조문비교차이무통계학의의.입원1주후재차비교량조각항검측지표,차이역균무통계학의의.결론 재위장도유효저위감압조건하,노년장경조환자급여장내영양시안전적.
Objective To explore the safety of enteral nutrition(EN)support in non-blood circulation disorders of elderly patients with intestinal obstruction.Methods A total of 40 patients (22 men and 18 women aged 62-84 years)with intestinal obstruction were enrolled in this study.Ileus tubes were rapidly placed in these patients with the assistance of endoscopy and X-ray.Afterwards patients were equally randomized into parenteral nutrition(PN)and EN(PN+EN)group and PN only group.The clinical outcomes and complications were recorded and compared.Results The average time for catheter placement was(24.83 4±7.95)minutes.Abdominal pain were relieved within 1-2 hours in26 pafienta(65.0%)and within 48 hours in 11 patients(27.5%).In the PN+EN group,EN was provided(25.25±8.17)hours after catheter placement,and most patients could tolerate EN.Laboratory findings were not significantly different at admission between two groups.The mean prealbumin leveh were below than normal level at admission but returned normal after one week,which were significantly different inside each group(P<0.05)but were not significantly different between these two groups.The triglyceride leveh were higher than the normal level at admission but returned normal after treatment;however,the difference between the two groups was not significant.The laboratories tests were also not significantly different between two groups one week after admission.Conclusion EN support is safe for elderly patients with intestinal obstruction after effective gastrointestinal decompression.
