精准肝切除围手术期病人肠内营养治疗的临床研究

··1222211．2238002．210008ENEN。54。ENENEN。、、、、。P＞0．05EN、P＜0．05。EN。R575R459．3A1007-810X201105-0266-03＊EarlyoralenteralnutritiontherapyafterpreciseliverresectionCHENZheng1QIUYu-dong2ZHOUJian-xin2ZHANGWei2ZHOUTie2FENGWei11．DepartmentofHepatobiliarySurgerySuqianPeople＇sHospitalofDrumTowerHospitalGrouptheMedicalCollegeofNanjingUniversityNanjing223800JiangsuChina2．DepartmentofHepatobiliarySurgeryofNanjingDrumTowerHospitalNanjing210008JiangsuChinaAbstractsObjectiveToobservetheimpactsofearlyenteralnutritionEENonpatientsre-ceivinghepatectomy．MethodsFrom06/2010to12/201054patientsundergoingpreciseliverresec-tionwereselectedforprospectivenon-randomizedcontrolstudyEENgroupn=27andcontrolgroupn=27．Thetwogroupswerecomparedwiththefollowingfactorsgastrointestinalfunctionliverfunctionivfluidhumanalbuminamountpost-operationtimeandcomplications．ResultsNosignificantdiffer-encewasfoundincomplicationsandliverfunction．Therewassignificantdifferenceingastrointestinalfunctionivfluidhumanalbuminamountanddaysofhospitalization．ConclusionEENisaneffectivenutritionaltreatmentafterhepatectomyanditcansignificantlyspeeduprecoveryprocess．KeywordsPreciseliverresectionEternalnutritionFasttracksurgery21。1－2。FTS3。EN。11．1201061254、·662·20119185Parenteral＆EnteralNutritionVol．18No．5September2011*。[e-mail]。391532～80。①18～80②③。①、②③④。、①EN2712h24hEN、、、、、500ml/d3d1000ml/d。②2724h3d。Child-Pugh、ICGR15、1。1Table1GeneralinformationoftwogroupsENn272756±1158±11/19/820/7HCC/ICC/MHC17/6/416/6/5/18/916/11/19/818/9/6/217/20ICGR156．36．0//Ⅰ/Ⅱ/3/4/12/5/32/5/12/6/2HCCICCMHC1．2“L”、、。PringleBelghiti。。CT。。。。1．31．3．117GPT、GOT、TBIL、ALP、GGT、ALB、CHE、LN。1．3．2、、、1。EN。1．4SPSS13．0。tχ2。P≤0．05。22．1。ENEN21000ml/d1、。2。11。32、。151。2．2EN、P＜0．052。2Table2ThecomparisonoftreatmentoutcomeintwogroupsENh60．4±21．448．4±10．0*h93．3±30．767．5±18．8*d12．8±2．710．4±2．5*g22．5±21．02．5±8．1**P＜0．052．3P＞0．053。2．4EN。3P＜0．011。·762·20119185Parenteral＆EnteralNutritionVol．18No．5September20113x±sTable3Thechangeofbiochemicalindicatorinpatientsbeforeandafteroperationx±sn=2717ENn=2717ALTU/L31．7±22．5294．8±175．965．0±24．934．6±22．0227．8±103．652．3±28．7ASTU/L34．8±17．9274．4±157．641．5±29．140．3±13．5234．4±99．539．3±13．7ALPU/L78．2±18．767．3±14．477．0±26．288．3±47．689．0±54．588．6±56．6GGTU/L47．5±33．647．8±22．177．4±50．079．3±106．173．6±68．0125．4±128．9TBILμmol/L14．9±5．622．4±9．814．4±8．614．3±5．217．3±8．613．5±7．9ALBg/L42．2±3．1833．7±2．735．2±2．443．1±4．031．9±4．135．2±2．9CHEU/L8．1±2．16．1±1．54．9±1．39．0±2．76．3±2．25．5±1．6LN×109/L1．4±0．40．6±0．31．2±0．31．5±0．40．6±0．21．2±0．41Figure1Thecomparisonofvolumeofpostoperativeinfusionintwogroups*P＜0．0134。、、5－6。。7－9。10。、EN。EN27、EN。EN、EN。ENEN。、。。。。EN。MCTMCT/LCT=1．5∶13100∶1MCT。MCTMCFA。MCFAATPLCFA11。LCFA。MCTEN。ENMCT。。。EN3。12。。【】1．．2007242133-134．271·862·20119185Parenteral＆EnteralNutritionVol．18No．5September2011、、、MODS。、、。EN1。EN。、GlnGln、、。Gln2。AA、、3。SIRSMODS、。4。GH-1IGF-1。GH。GHGln-2IL-2IL-2R。Karl5GHGH。GH。【】1．-．2006865295-299．2．．2009303359-361．3．ω-3．200714154-58．4．．200714110-12．5KarlJQRainerD．Increasedmortalityassociatedwithgrowthhor-monetreatmentincriticallyilladults．NEnglJMed20003422134-136．2010-05-092011-04-15櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓櫓2682．．20098285-87．3．．2007272131-133．4．．20022311-4．5．．2010372140-142．6．．200947211606-1609．7．．2002105323-324．8．．20012110620-622．9RichterBSchmandraTCGollingMetal．Nutritionalsupportaf-teropenliverresectionasystematicreview．DigSurg2006233139-145．10VanDamRMHendryPOCoolsenMMetal．Initialexperi-encewithamultimodalenhancedrecoveryprograminpatientsun-dergoingliverresection．BrJSurg2008958969-975．11JeukendrupAEAldredS．Fatsupplementationhealthanden-duranceperformance．Nutrition2004207-8678-688．12．．200035203-205．2011-04-212011-08-31·172·20119185Parenteral＆EnteralNutritionVol．18No．5September2011