海南医科大学学报

目的:探讨不同营养支持方法对腹部术后功能性胃排空障碍的临床疗效。方法:选取我院胃肠外科收治的腹部手术后功能性胃排空障碍的90例患者,随机分为观察组和对照组各45例。两组均给予基础治疗措施,观察组给予肠内营养支持,对照组给予肠外营养支持,对比两组术后住院天数、胃排空恢复天数、术后患者体质量的减少量、胃引流量和免疫功能的变化情况。结果:观察组的术后住院天数、胃排空恢复天数以及术后体质量减少量均显著少于对照组,差异均有统计学意义(P<0.05)。两组术后第1d的胃管引流量比较,差异无统计学意义(P>0.05),而在术后第7d以及术后第14d,观察组胃管引流量均显著少于对照组,差异均有统计学意义(P<0.05)。术后第1d,两组IgA、IgM和IgG浓度均显著低于术前;术后第7d,观察组的IgA、IgM和IgG浓度显著高于对照组(P<0.05)。观察组和对照组的不良反应发生率分别为20.00%、33.33%,两组对比具有显著的统计学差异(P<0.05)。结论:肠内营养支持是腹部手术后功能性胃排空障碍药物保守治疗的重要手段,对促进患者胃肠道功能和免疫功能的恢复以及缩短患者病程均有积极的意义。

Objective:To compare the clinical effect of different nutritional therapies for delayed gastric emptying.Methods:A total of 90patients with delayed gastric emptying were selected and randomly divided into observation group and control group with 45cases in each.All patients were given basic treatment.Patients in observation group were treated with enteral nutrition and the control group were treated with parenteral alimentation.Length of stay,gastric emptying recovery time,postoperative weight reduction,gastric drainage volume and immunity of the two groups were observed and compared.Results: Length of stay,the recovery time of gastric emptying and postoperative weight reduction of the observation group were significantly less than the control group.There were significantly statistical differences between two groups(P<0.05).There was no statistically significant differences in the gastric drainage volume on the 1st day(P>0.05),but it was significant on the7th day and 14th day(P<0.05).On the 1st day after operation,IgA,IgM and IgG concentrations in all patients were significantly lower than those before treatment.On the 7th day after operation,the IgA,IgM and IgG concentrations of the observation group were significantly higher than those in the control group(P<0.05).The incidence of adverse reaction of the observation group was 20%,and the control group was 33.33%.There was significantly statistical difference between two groups(P<0.05).Conclusions:Enteral nutrition is an important treatment for functional delayed gastric emptying.It can promote gastrointestinal function and immunity recovery and shorten the course of disease.