中华普通外科学文献（电子版）
中華普通外科學文獻（電子版）
중화보통외과학문헌（전자판）
Chinese Archives of General Surgery(Electronic Edition)
2015年
6期
446-450
,共5页
范明明%赵辉%傅斌生%安玉玲%易小猛%刘剑戎%易慧敏
範明明%趙輝%傅斌生%安玉玲%易小猛%劉劍戎%易慧敏
범명명%조휘%부빈생%안옥령%역소맹%류검융%역혜민
肝移植%肠道营养%术后%感染
肝移植%腸道營養%術後%感染
간이식%장도영양%술후%감염
Liver transplantation%Enteral nutrition%Postoperation%Infection
目的 探讨肝移植术后早期肠内营养对患者感染发生率的影响.方法 收集2012年6月至2015年1月于本中心行肝移植手术的全部病例,进行前瞻性队列研究.共有177例患者参与研究,其中60例在术后24 h内开展肠内营养,辅以肠外营养(试验组);117例早期予以全肠外营养,直至患者肛门排气后开始肠内营养(对照组).根据患者术前的MELD评分进行分级,观察早期肠内营养对不同MELD评分的患者肝移植术后感染的影响.结果 177例患者中共有106例(59.9%)发生术后感染.性别、MELD评分与早期肠内营养3个变量为影响总感染率的独立危险因素(P=0.027、0.045、0.000).早期肠内营养可以降低11≤MELD评分≤20患者的术后感染发生率(P=0.014).随着MELD评分增加,早期肠内营养对感染发生率的影响逐渐缩小.结论 早期肠内营养可降低中度终末期肝病患者肝移植术后感染发生率.
目的 探討肝移植術後早期腸內營養對患者感染髮生率的影響.方法 收集2012年6月至2015年1月于本中心行肝移植手術的全部病例,進行前瞻性隊列研究.共有177例患者參與研究,其中60例在術後24 h內開展腸內營養,輔以腸外營養(試驗組);117例早期予以全腸外營養,直至患者肛門排氣後開始腸內營養(對照組).根據患者術前的MELD評分進行分級,觀察早期腸內營養對不同MELD評分的患者肝移植術後感染的影響.結果 177例患者中共有106例(59.9%)髮生術後感染.性彆、MELD評分與早期腸內營養3箇變量為影響總感染率的獨立危險因素(P=0.027、0.045、0.000).早期腸內營養可以降低11≤MELD評分≤20患者的術後感染髮生率(P=0.014).隨著MELD評分增加,早期腸內營養對感染髮生率的影響逐漸縮小.結論 早期腸內營養可降低中度終末期肝病患者肝移植術後感染髮生率.
목적 탐토간이식술후조기장내영양대환자감염발생솔적영향.방법 수집2012년6월지2015년1월우본중심행간이식수술적전부병례,진행전첨성대렬연구.공유177례환자삼여연구,기중60례재술후24 h내개전장내영양,보이장외영양(시험조);117례조기여이전장외영양,직지환자항문배기후개시장내영양(대조조).근거환자술전적MELD평분진행분급,관찰조기장내영양대불동MELD평분적환자간이식술후감염적영향.결과 177례환자중공유106례(59.9%)발생술후감염.성별、MELD평분여조기장내영양3개변량위영향총감염솔적독립위험인소(P=0.027、0.045、0.000).조기장내영양가이강저11≤MELD평분≤20환자적술후감염발생솔(P=0.014).수착MELD평분증가,조기장내영양대감염발생솔적영향축점축소.결론 조기장내영양가강저중도종말기간병환자간이식술후감염발생솔.
Objective To explore the influences of early enteral nutrition (EN) in the incidence of postoperative infection for patients after liver transplantation. Methods All the liver transplant pa-tients between June 2012 and January 2015 in our center were collected in a prospective cohort study. This study enrolled 177 patients, including 60 patients in early enteral group who started initial enteral nu-trition within 24 hours after surgery, and 117 patients who started with total parenteral nutrition (TPN) and did not start EN until anus exhaustion or defecation. Patients were classified according to the Model for End Stage Liver Disease(MELD)score. The effect of early enteral nutrition at different levels were ana-lyzed to view whether the effect in patients with different levels was selective. Results One hundred and six cases (59.9%) were reported postoperative infection. Gender, MELD score and early enteral nutrition were independent risk factors affecting total infection rate (P=0.027, 0.045, 0.000). Early enteral nutrition reduced the infection rate in less severe patients, especially in patients whose MELD score was between 11-20 (P=0.014). With the increase of MELD score, the influence of early enteral nutrition on infection rates gradually narrowed. Conclusion Early enteral nutrition can significantly reduce the incidence of infection in patients with medium MELD score after transplantation.
