中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2011年
17期
2001-2004
,共4页
王栩%阎成美%谢海英%赵婷鹭%江艺
王栩%閻成美%謝海英%趙婷鷺%江藝
왕허%염성미%사해영%조정로%강예
肠内营养%肝移植%鼻胃管%经胃空肠管%终末期肝病模型(MELD)评分%受者
腸內營養%肝移植%鼻胃管%經胃空腸管%終末期肝病模型(MELD)評分%受者
장내영양%간이식%비위관%경위공장관%종말기간병모형(MELD)평분%수자
Enteral nutrition%Liver transplantation%Nasogastric tube%Gastrostomy-jejunal tube%Model for end-stage liver disease(MELD) score%Recipient
目的 探讨肝移植受者术后早期肠内营养途径的选择.方法 以肝移植术后进行早期肠内营养的96例患者作为研究对象,根据肠内营养的方式不同分为鼻胃管组42例和经皮经胃空肠管组54例,统计两组病例的术前一般状况、营养状况、基础疾病等,对比观察两种肠内营养途径的相关并发症及治疗结果.结果 与鼻胃管组比较,经皮经胃空肠管组术后营养管开始时间显著提前[(2.33±0.25)d比(0.52±0.12)d,t=46.770,P<0.01],营养管有效使用时间延长[(8.7±3.9)d比(28.6±17.9)d,t=7.071,P<0.01],术后第3~7天通过营养管的补充量均显著增高,差异均具有统计学意义(P<0.01).在Meld评分>15分的情况下,经皮经胃空肠管组胃潴留[5.1%比25.0%,χ2=5.736,P=0.035],管道意外脱出发生率[0.0%比12.5%,χ2=5.166,P=0.037]以及术后住院时间和术后一期出院费用均显著低于鼻胃管组(P<0.05),而腹泻和管道堵塞发生率差异无统计学意义(P>0.05).不同Meld评分情况下,两组间肺部感染、腹腔感染、急性肾衰竭和急性排斥发生差异均无统计学意义(P>0.05).结论 对于Meld>15分的患者,采用经皮经胃空肠管进行术后早期肠内营养更具优势,值得推广.
目的 探討肝移植受者術後早期腸內營養途徑的選擇.方法 以肝移植術後進行早期腸內營養的96例患者作為研究對象,根據腸內營養的方式不同分為鼻胃管組42例和經皮經胃空腸管組54例,統計兩組病例的術前一般狀況、營養狀況、基礎疾病等,對比觀察兩種腸內營養途徑的相關併髮癥及治療結果.結果 與鼻胃管組比較,經皮經胃空腸管組術後營養管開始時間顯著提前[(2.33±0.25)d比(0.52±0.12)d,t=46.770,P<0.01],營養管有效使用時間延長[(8.7±3.9)d比(28.6±17.9)d,t=7.071,P<0.01],術後第3~7天通過營養管的補充量均顯著增高,差異均具有統計學意義(P<0.01).在Meld評分>15分的情況下,經皮經胃空腸管組胃潴留[5.1%比25.0%,χ2=5.736,P=0.035],管道意外脫齣髮生率[0.0%比12.5%,χ2=5.166,P=0.037]以及術後住院時間和術後一期齣院費用均顯著低于鼻胃管組(P<0.05),而腹瀉和管道堵塞髮生率差異無統計學意義(P>0.05).不同Meld評分情況下,兩組間肺部感染、腹腔感染、急性腎衰竭和急性排斥髮生差異均無統計學意義(P>0.05).結論 對于Meld>15分的患者,採用經皮經胃空腸管進行術後早期腸內營養更具優勢,值得推廣.
목적 탐토간이식수자술후조기장내영양도경적선택.방법 이간이식술후진행조기장내영양적96례환자작위연구대상,근거장내영양적방식불동분위비위관조42례화경피경위공장관조54례,통계량조병례적술전일반상황、영양상황、기출질병등,대비관찰량충장내영양도경적상관병발증급치료결과.결과 여비위관조비교,경피경위공장관조술후영양관개시시간현저제전[(2.33±0.25)d비(0.52±0.12)d,t=46.770,P<0.01],영양관유효사용시간연장[(8.7±3.9)d비(28.6±17.9)d,t=7.071,P<0.01],술후제3~7천통과영양관적보충량균현저증고,차이균구유통계학의의(P<0.01).재Meld평분>15분적정황하,경피경위공장관조위저류[5.1%비25.0%,χ2=5.736,P=0.035],관도의외탈출발생솔[0.0%비12.5%,χ2=5.166,P=0.037]이급술후주원시간화술후일기출원비용균현저저우비위관조(P<0.05),이복사화관도도새발생솔차이무통계학의의(P>0.05).불동Meld평분정황하,량조간폐부감염、복강감염、급성신쇠갈화급성배척발생차이균무통계학의의(P>0.05).결론 대우Meld>15분적환자,채용경피경위공장관진행술후조기장내영양경구우세,치득추엄.
Objective To explore the choice of pathway of early enteral nutrition after orthotopic liver transplantation.Methods 96 liver transplantation recipients were separated into nasogastric tube group(42 cases) and gastrostomy-jejunal tube group (54 cases) in our center. The preoperative general condition, nutritional status and basic diseases in two groups were collected. The complications and treatment results of two groups were compared.Results Compared with nasogastric tube group, the start time of enteral nutrition was significantly advanced[(2.33±0.25) vs (0.52±0.12), t=46.770,P<0.01]; the effective use of time of the feeding tube was markedly extended [(8.7±3.9) vs (28.6±17.9),t=7.071, P<0.01]; the supplementary from the third to the 7th day were observably increased in the gastrostomy-jejunal tube group(P<0.01). In Meld score above 15, incidence of gastric retention[5.1%(2/39) vs 25%(8/32), χ2=5.736,P=0.035] and the feeding tube accidently pulled out[0 vs 12.5%(4/32),χ2=5.166,P=0.037], postoperative hospital stay and hospital costs in gastrostomy-jejunal tube group were significantly lower than that of nasogastric tube group(P<0.05). The incidence of diarrhea and tube blockage was no significant difference(P>0.05). Meld score in different circumstances, between the two groups of pulmonary infection, abdominal infection, acute renal failure and acute rejection were not significantly different(P>0.05).Conclusions The use of percutaneous gastrostomy-jejunal tube has the advantages of early postoperative enteral nutrition in patients with Meld score above 15 ,it is worth to apply.
