中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2015年
4期
225-228
,共4页
营养支持%胰十二指肠切除术%手术后并发症
營養支持%胰十二指腸切除術%手術後併髮癥
영양지지%이십이지장절제술%수술후병발증
Nutritional support%Pancreaticoduodenectomy%Postoperative complication
目的 探讨术前营养支持对存在营养风险的胰十二指肠切除术后患者临床结局的影响.方法 收集2011年6月到2013年9月在武汉大学人民医院肝胆腔镜外科接受胰十二指肠切除术的患者46例,按入院顺序进行编号,然后按随机数字表法分为研究组(术前接受营养支持)23例,对照组(术前不接受营养支持)23例.观察两组患者术前、术后营养状况,并发症发生率,住院时间,住院期间的费用.结果 研究组的手术时间及术中出血量均较对照组显著减少[(340±90)min比(420±104) min,(761±100) ml比(901±150) ml,P值均＜0.01];术前1d及术后1、7、14 d的血清白蛋白水平均显著高于对照组[术后7d为(30.6±1.8)g/L比(24.6±2.2) g/L,P值均＜0.05];术前1d及术后1、7d的转铁蛋白水平均显著高于对照组[术后7d为(3.23 ±0.65)g/L比(2.38±0.49)g/L,P值均＜0.05];术后并发症发生率显著低于对照组(52.2％比21.7％,P=0.000).研究组患者较对照组患者更早开始肛门排气[(6.4±0.6)d比(9.5±0.6)d,P=0.000],且住院时间更短[(20.1±6.5)d比(26.7±9.5)d,P=0.014],住院总费用更少[(9.9±1.3)万元比(11.5±1.3)万元,P=0.000],而住院期间营养支持费用无明显差异(P=0.210).结论 对于胰十二指肠切除术的患者,手术前行营养支持能显著降低患者术后并发症的发生,缩短住院时间,减少住院费用.
目的 探討術前營養支持對存在營養風險的胰十二指腸切除術後患者臨床結跼的影響.方法 收集2011年6月到2013年9月在武漢大學人民醫院肝膽腔鏡外科接受胰十二指腸切除術的患者46例,按入院順序進行編號,然後按隨機數字錶法分為研究組(術前接受營養支持)23例,對照組(術前不接受營養支持)23例.觀察兩組患者術前、術後營養狀況,併髮癥髮生率,住院時間,住院期間的費用.結果 研究組的手術時間及術中齣血量均較對照組顯著減少[(340±90)min比(420±104) min,(761±100) ml比(901±150) ml,P值均＜0.01];術前1d及術後1、7、14 d的血清白蛋白水平均顯著高于對照組[術後7d為(30.6±1.8)g/L比(24.6±2.2) g/L,P值均＜0.05];術前1d及術後1、7d的轉鐵蛋白水平均顯著高于對照組[術後7d為(3.23 ±0.65)g/L比(2.38±0.49)g/L,P值均＜0.05];術後併髮癥髮生率顯著低于對照組(52.2％比21.7％,P=0.000).研究組患者較對照組患者更早開始肛門排氣[(6.4±0.6)d比(9.5±0.6)d,P=0.000],且住院時間更短[(20.1±6.5)d比(26.7±9.5)d,P=0.014],住院總費用更少[(9.9±1.3)萬元比(11.5±1.3)萬元,P=0.000],而住院期間營養支持費用無明顯差異(P=0.210).結論 對于胰十二指腸切除術的患者,手術前行營養支持能顯著降低患者術後併髮癥的髮生,縮短住院時間,減少住院費用.
목적 탐토술전영양지지대존재영양풍험적이십이지장절제술후환자림상결국적영향.방법 수집2011년6월도2013년9월재무한대학인민의원간담강경외과접수이십이지장절제술적환자46례,안입원순서진행편호,연후안수궤수자표법분위연구조(술전접수영양지지)23례,대조조(술전불접수영양지지)23례.관찰량조환자술전、술후영양상황,병발증발생솔,주원시간,주원기간적비용.결과 연구조적수술시간급술중출혈량균교대조조현저감소[(340±90)min비(420±104) min,(761±100) ml비(901±150) ml,P치균＜0.01];술전1d급술후1、7、14 d적혈청백단백수평균현저고우대조조[술후7d위(30.6±1.8)g/L비(24.6±2.2) g/L,P치균＜0.05];술전1d급술후1、7d적전철단백수평균현저고우대조조[술후7d위(3.23 ±0.65)g/L비(2.38±0.49)g/L,P치균＜0.05];술후병발증발생솔현저저우대조조(52.2％비21.7％,P=0.000).연구조환자교대조조환자경조개시항문배기[(6.4±0.6)d비(9.5±0.6)d,P=0.000],차주원시간경단[(20.1±6.5)d비(26.7±9.5)d,P=0.014],주원총비용경소[(9.9±1.3)만원비(11.5±1.3)만원,P=0.000],이주원기간영양지지비용무명현차이(P=0.210).결론 대우이십이지장절제술적환자,수술전행영양지지능현저강저환자술후병발증적발생,축단주원시간,감소주원비용.
Objective To investigate the effects of preoperative nutrition support on postopreative clinical outcome in patients with nutritional risk with pancreaticoduodenectomy.Methods Forty six patients with pancreaticoduodenectomy complicated with malnutrition from June 2011 to September 2013 in Department of Hepatobiliary and Lapoaroscopic Surgery of People's Hospital of Wuhan University were randomly divided into experimental group (n =23) and control group (n =23) with random number table,patients in experimental group received preoperative nutrition support,but patients in control group did not receive preoperative nutrition support.The preoperative and postoperative nutritional status,the incidence of postoperative complications,the length of hospital stay,and the cost of hospitalization in the two groups of patients was compared.Results In terms of intra-operative blood loss and the operative time,experimental group was significantly lower than those in control group [(340 ±90)min vs (420 ± 104)min,(761 ± 100)ml vs (901 ± 150)ml,P＜0.01],on the 1st day of preoperation,the 1st day,7th day and 14th day of post operation,the levels of serum albumin was significantly higher than those in control group [(30.6 ± 1.8) g/L vs (24.6±2.2) g/L on the,P＜0.05];and on the 1st day of pre-operation,the 1st day,7th day of post operation,the levels of transferrin were significantly higher in experimental group than in control group [(3.23 ± 0.65) g/L vs (2.38 ± 0.49) g/L on the,P ＜ 0.05);the rate of post operative complication were significantly lower in experimental group than that in control group (52.2％ vs 21.7％,P=0.000);the postoperative anal exhaust time was earlier in experimental group than that in control group [(6.4 ± 0.6) d vs (9.5 ± 0.6) d,P =0.000),and the length of hospital stay was shorter in experimental group [(20.1 ± 6.5) d vs (26.7 ± 9.5) d,P =0.014),and the cost in experimental group was lower [(99 ± 13) thousand yuan vs (115 ± 13) thousand yuan,P =0.000),however,the cost of nutrition support between the two groups was not significantly different (P =0.210).Conclusions Preoperative nutrition support is helpful to reduce the incidence of postoperative complications,shorten the length of hospital stay,to save medical costs for patients with pancreaticoduodenectomy.
