CAJ | 학술논문

目的：观察消化道息肉糖尿病患者在无痛胃肠镜下行氩气刀凝固术后应用综合营养干预的效果。方法选取2011年4~11月该院消化内科确诊为消化道息肉的糖尿病患者60例，经无痛胃肠镜下行氩气刀凝固术，并随机分为对照组和干预组，各30例。对照组患者仅给予膳食指导，干预组患者在膳食指导基础上给予肠内综合营养支持等。观察两组患者术前、术后血糖相关指标的变化、胃肠耐受情况和术后不良反应及并发症发生情况。结果干预组患者术后第3、5、10天餐后2小时血糖（2hPBG）水平较术前降低，且较对照组降低更明显，而对照组患者术后第3天2hPBG水平较术前升高，差异均有统计学意义（P＜0.05）；干预组患者术后第10天糖化血红蛋白较对照组明显下降，但差异无统计学意义（P>0.05）；干预组患者在腹泻、餐后伤口隐痛方面与对照组比较，差异有统计学意义（P＜0.05）。对照组患者不良反应发生率（6.7%）高于干预组（0.0%），差异有统计学意义（P＜0.05）。对照组有1例患者大便隐血试验呈阳性（++），干预组未发生并发症。结论对消化道息肉糖尿病患者在无痛胃肠镜下行氩气刀凝固术后给予综合营养干预可有效控制血糖波动，并明显改善患者营养状况，有利于其康复。
목적：관찰소화도식육당뇨병환자재무통위장경하행아기도응고술후응용종합영양간예적효과。방법선취2011년4~11월해원소화내과학진위소화도식육적당뇨병환자60례，경무통위장경하행아기도응고술，병수궤분위대조조화간예조，각30례。대조조환자부급여선식지도，간예조환자재선식지도기출상급여장내종합영양지지등。관찰량조환자술전、술후혈당상관지표적변화、위장내수정황화술후불량반응급병발증발생정황。결과간예조환자술후제3、5、10천찬후2소시혈당（2hPBG）수평교술전강저，차교대조조강저경명현，이대조조환자술후제3천2hPBG수평교술전승고，차이균유통계학의의（P＜0.05）；간예조환자술후제10천당화혈홍단백교대조조명현하강，단차이무통계학의의（P>0.05）；간예조환자재복사、찬후상구은통방면여대조조비교，차이유통계학의의（P＜0.05）。대조조환자불량반응발생솔（6.7%）고우간예조（0.0%），차이유통계학의의（P＜0.05）。대조조유1례환자대편은혈시험정양성（++），간예조미발생병발증。결론대소화도식육당뇨병환자재무통위장경하행아기도응고술후급여종합영양간예가유효공제혈당파동，병명현개선환자영양상황，유리우기강복。
Objective To observe the effect of enternal nutrition intervention in the gastrointestinal polyps patients with diabetes (DM) after painless gastroscope argon coagulation. Methods From April to November 2011,60 gastrointestinal polyps patients with DM undergoing gastroscope argon coagulation were included and divided into the control group and the intervention group,30 of each group. The patients in the control group were only guided in diet instruction,while those in the intervention group were added comprehensive enteral nutrition support based on the diet instruction. It was observed the change of related glycemic indexes before and after the operation,gastrointestinal tolerance,postoperative adverse effect as well as complications. Results The postopervative patients′2hPBG level in the intervention group on the 3rd,5th,10th day was lower than that before the operation and of the control group, while the 2hPBG level after operation in the control group was improved than that before operation(P<0.05);The patients′glycosylated hemoglobin level in the intervention group was lower than that of the control group (P>0.05). Compared the diarrhea and wound dull pain,the two groups had statistical significance(P<0.05);The occurrence rate of adverse reaction(6.7%),complications occurrence rate(3.3%) in the control group was lower than that (0.0%) of the intervention group,whose differences were statistically significant(P<0.05). Conclusion Enternal nutrition intervention can control their blood glucose effectively,improve their nutrition status obviously,being beneficial to the rehabilitation of patients.