Clinical values of early enteral nutrition combined with Shenmai injection in patients with open surgery of digestive tract
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摘要: 目的 本研究旨在探讨早期参麦注射液联合肠内营养对消化道开腹手术患者术后肠道功能和免疫功能的影响。 方法 前瞻性收集2011年1月—2015年6月临海市第一人民医院收治的消化道腹部手术患者120例,将患者随机分为观察组和对照组。观察组术后给予参麦注射液和肠内营养。对照组术后给予肠外营养。主要观察指标是免疫球蛋白A (IgA)、免疫球蛋白G (IgG)、免疫球蛋白M (IgM)和白蛋白。次要观察指标是术后并发症:消化道瘘、恶心、呕吐、腹泻、发热、腹痛和肛门排气时间。 结果 2组患者入院时性别、年龄、BMI、原发病部位、术前及术后1 d的IgA、IgG、IgM和白蛋白等差异均无统计学意义(P>0.05)。但与对照组比较,观察组术后8 d时IgA、IgG、IgM和白蛋白均显著增高,差异有统计学意义(均P<0.001);观察组患者术后腹泻发生率显著降低(11.67% vs.25.00%,P=0.037);肛门排气时间显著缩短[(1.42±0.50) d vs.(2.03±0.80) d,P<0.001]。2组患者术后消化道瘘、恶心、呕吐、发热和腹痛等发生率差异均无统计学意义(均P>0.05)。 结论 早期参麦注射液联合肠内营养显著改善了开腹手术患者术后肠道功能和免疫功能。Abstract: Objective To investigate the influences of early enteral nutrition combined with ShenMai injection on intestinal functions and immunologic functions in patients with open surgery of digestive tract. Methods From January,2011 to June,2015,120 patients undergoing the open surgery of digestive tract in our hospital were enrolled in this prospective study.The patients were randomly assigned into observational group and control group.Early enteral nutrition combined with ShenMai injection was given to the observational group while parenteral nutrition was given to the control group.The primary outcomes included immunoglobulin A,immunoglobulin G,immunoglobulin M and albumin.The secondly primary outcomes included digestive tract fistula,nausea,vomiting,diarrhea,fever,abdominal pain and anal exhaust time. Results There was no differences between two groups in gender,age,BMI,primary site of disease,preoperative and 1-day postoperative immunoglobulin A,immunoglobulin G,immunoglobulin M and albumin(P>0.05).However,when compared with the control group,the patients in observational group got a significantly increase in 8-days postoperative immunoglobulin A,immunoglobulin G,immunoglobulin M and albumin(P<0.001);a significantly lower rate of diarrhea(11.67% vs. 25.00%,P=0.037);a significantly shorter of anal exhaust time[(1.42±0.50)d vs. (2.03±0.80) d,P<0.001].There was no difference in digestive tract fistula,nausea,vomiting,fever and abdominal pain(P<0.05). Conclusion Early enteral nutrition combined with ShenMai injection can improve the intestinal functions and immunologic functions in patients with open surgery of digestive tract.
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