Early Enteral Nutrition in Neonates with Partial Gastrectomy-A Multi-center Study

早期肠内营养在新生儿胃部分切除术中的运用—一个多中心研究

Wei-Wei Jiang ； Jie Zhang ； Qi-Ming Geng ； Xiao-Qun Xu ； Xiao-Feng Lv ； Yong-Wei Chen ； Xiang Liu ； Wei-Bing Tang

《Asia Pacific Journal of Clinical Nutrition》 預刊文章 Pp. 42-55

https://doi.org/10.6133/apjcn.2016.25.1.16

摘要

背景：研究表明肠内营养比完全肠外营养更适合在术后运用。本文主要目的是研究新生儿胃部分切除术后运用空肠营养管的安全性和可行性。方法：我们回顾性研究46例胃穿孔行胃部分切除术的病人。这些病人被分为两组，早期肠内营养组（24例），空肠营养管在术中放置；完全肠外营养组即对照组（22例），未放置空肠营养管。我们比较两组的手术时间、术后首次排便时间、术后首次经口喂养时间，术后住院时间，营养指标、术后并发症如脓毒症导致的死亡率，胆汁淤积、肺炎、肠粘连、腹泻等。结果：手术时间和术后首次经口喂养时间两组间没有显著性差异。术后首次排便时间和术后住院时间肠内营养组均明显短于完全肠外营养组。术后14天时总蛋白、视黄醇结合蛋白前及白蛋白肠内营养组明显高于完全肠外营养组。胆汁淤积和肠梗阻的发生率肠内营养组明显低于完全肠外营养组。结论：采用空肠营养管的早期肠内营养方法在新生儿胃穿孔行胃部分切除术后使用是安全和可行的，并且并发症较少。

關鍵字

早期肠内营养 ； 胃部分切除术 ； 新生儿 ； 完全肠外营养 ； 胃穿孔

並列摘要

〞Background〞: Compared with total parenteral nutrition (TPN), enteral nutrition is more suitable for patients post-operatively. Our aim was to determine the safety and feasibility of early enteral nutrition (EEN) using a jejunum feeding tube in neonates after undergoing a partial gastrectomy. Methods: This was a retrospective review of 46 patients who underwent partial gastrectomies for gastric perforation in our hospital. These patients were categorized into two groups (EEN group [n=24 patients], a jejunal feeding tube was inserted during surgery; and a control group [n=22 patients], a jejunal feeding tube was not placed). Differences in operative time, time to first defecation post-operatively, time to first oral feeding post-operatively, length of hospital stay post-operatively, nutrition indices, and post-operative complications (died due to septic shock, cholestasis, pneumonia, abdominal distension, and diarrhea) were reviewed. Results: There were no significant differences in the operative time and the time to first oral feeding post-operatively between the two groups; however, the time to first defecation post-operatively in the EEN group and the hospital length of stay post-operatively for the EEN group were significantly shorter than the control group. The levels of albumin, retinol binding protein, and prealbumin were not significantly different between the two groups pre-operatively and 14 days post-operatively. The incidence of cholestasis and abdominal distention in the EEN group was significantly lower than the control group. Conclusion: EEN using a jejunal feeding tube in neonates who have undergone a partial gastrectomy for gastric perforation is safe, easy, and has fewer complications than TPN.

並列關鍵字

early enteral nutrition ； partial gastrectomy ； neonate ； total parenteral nutrition ； gastric perforation