早期肠内营养对胃穿孔术后患者应激水平的影响

董聪颖1 ，王甫清1，王智浩1，杜桂芹2，刘守田3

（1.黄岛区第二人民医院；2. 黄岛区人民医院；3.黄岛区卫生计生局，山东 青岛，266400）

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摘要：

目的 观察早期进食肠内营养对胃穿孔术后患者应激水平的影响。方法 将我院2014年5月至2016年5月收治的58例胃穿孔患者随机分为观察组和对照组，每组29例。观察组患者术后早期采用少量多次给予肠内营养；对照组患者应用常规围手术期的治疗方式。比较两组患者术后恢复情况、并发症发生率、术后营养状况及应激水平等。结果 观察组并发症发生率为13.8%，对照组为17.2%，组间比较，差异无统计学差异（P>0.05）；观察组患者术后营养情况、应激水平（CRP、SOD、MDA）明显优于对照组（P<0.05）；观察组患者与对照组患者术后肛门排气时间（[53.11±11.18）h vs（.65.16±9.24）h] 、术后住院天数（[6.02± 0.96）d vs（.7.54±0.97）d]和住院费用（[7 992.8±985.0）元vs.（8 927.8±1 115.0）元]比较，差异均有统计学意义（P<0.05）。结论 早期进食肠内营养制剂能够改善胃穿孔术后患者营养情况及应激水平，促进胃肠道功能恢复，并减少医疗费用。

关键词：胃穿孔；早期肠内营养；营养状况；应激反应

中图分类号：R735.2文献标志码：A文章编号：2096-1413(2017)13-0072-03

Effect of early oral enteral nutrition on stress reaction after gastric perforation surgery
DONG Cong-ying 1, WANG Fu-qing 1, WANG Zhi-hao 1, DU Gui-qin 2, LIU Shou-tian 3
(1. the Second People s Hospital of Huangdao District; 2. the People s Hospital of Huangdao District; 3. Health and Family Planning Bureau of Huangdao District, Qingdao 266400, China)

ABSTRACT: Objective To investigate the effect of early oral feeding with enteral nutrition preparation on stress reaction in patients after gastric perforation surgery. Methods Fifty-eight cases of patients with gastric perforation from May 2014 to May 2016 in our hospital were selected and randomly divided into experimental group (n=29) and control group (n=29). Patients in the experimental group administrated little enteral nutrition several times early after surgery. Patients in the control group received conventional postoperative treatment. The postoperative recovery, complication rate, postoperative nutritional status and stress levels in both groups were compared. Results The complication rate was 13.8% in the observation group and 17.2% in the control group，and there was no significant difference between the two groups (P>0.05). The postoperative nutritional status, stress levels (CRP, SOD, MDA) in the observation group were significantly better than those in the control group (P<0.05). In the observation group and control group, the postoperative anal exhaust time were [(53.11±11.18) h vs. (65.16±9.24) h], the postoperative hospital stay were [(6.02±0.96) d vs. (7.54±0.97) d] and hospitalization costs were [(7 992.8±985.0) yuan vs. (8 927.8±1 115.0) yuan], the differences between the two groups were statistically significant (P<0.05). Conclusion Early oral enteral nutrition preparation after gastric perforation surgery can improve the nutritional status and stress reaction, accelerate the recovery for patients, and reduce the health care costs.
KEYWORDS: gastric perforation; early enteral nutrition; nutritional status; stress reaction

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