Advances in the enteral nutritional support treatment for patients after digestive tract reconstruction
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摘要: 消化道重建术后患者存在营养不良及吸收障碍风险, 肠内营养支持能更有效地维持和改善机体的营养状态, 缩短住院时间以及减少并发症的发生, 是术后首选的营养支持方式。本文将消化道重建术后患者肠内营养支持开始的时机、营养支持途径、营养制剂、输注方式的选择, 以及并发症的治疗等方面进行综述。Abstract: Postoperative patients who underwent digestive tract reconstruction have a high risk of malnutrition and absorbing barrier. Enteral nutrition support can effectively maintain and improve the nutritional status of the human body, shorten hospital stay, and reduce complications. Therefore, the enteral approach is the preferred postoperative means of nutrition support. This article retrospectively summarizes the appropriate time to start enteral nutrition support therapy after digestive tract reconstruction, the proper selection of the mode of enteral nutrition support, the different enteral nutrition preparations, and the treatment of postoperative complications.
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[1] 丁一娟.上消化道重建术后的营养支持[J].临床外科杂志, 2006, 14(8), 480. doi: 10.3969/j.issn.1005-6483.2006.08.008Ding YJ. Nutritional support in patients after upper digestive tract reconstruction[J]. Journal of Clinical Surgery, 2006, 14(8), 480. doi: 10.3969/j.issn.1005-6483.2006.08.008 [2] 狄淑群, 彭宏伟.上消化道重建术后肠内肠外联合序贯营养支持[J].江苏医药, 2007, 33(11), 1166-1168. doi: 10.3969/j.issn.0253-3685.2007.11.039Di SQ, Peng HW. Combined and sequential enteral and parenteral nutrition after Upper digestive tract reconstruction[J]. Jiangsu Medical Journal, 2007, 33(11), 1166-168. doi: 10.3969/j.issn.0253-3685.2007.11.039 [3] 成红刚, 丁连安, 牛冬光等.上消化道重建术后早期肠内营养临床有效性研究[J].中国现代普外科进展, 2010, 13(12), 967-969. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgxdptwkjz201012013Cheng HG, Ding LA, Niu DG, et al. Applicationg of early nutrition for patients with reconstruction of the upper gastrointestinal tract[J]. Chinese Journal of Current Advances in General Surgery, 2010, 13(12), 967-969. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgxdptwkjz201012013 [4] Lewis SJ, Andersen HK, Thomas S. Early Enteral Nutrition Within 24 h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematicreview and Meta-analysis[J]. J Gastrointest Surg, 2009, 13(3):569-575. doi: 10.1007/s11605-008-0592-x [5] Barlow R, Price P, Reid TD, et al. Prospective multicentre randomised controlled trial of early enteral nutrition for patients undergoing major upper gastrointestinal surgical resection[J]. Clin Nutr, 2011, 30(5):560-566. doi: 10.1016/j.clnu.2011.02.006 [6] 田莉莉, 李丽, 赵洁, 等.恶性梗阻性黄疸患者术后肠内营养开始时机的研究[J].肠外与肠内营养, 2008, 15(4), 225-231. doi: 10.3969/j.issn.1007-810X.2008.04.009Tian LL, Li L, Zhao J, et al. A study on the timing of enteral nutrition in postoperative patients with malignant obstructive jaundice[J]. Parenteral & Enteral Nutrition, 2008, 15(4):225-231. doi: 10.3969/j.issn.1007-810X.2008.04.009 [7] Velez JP, Lince LF, Restrepo JI. Early Enteral Nutrition in Gastrointestinal Surgery: A Pilot Studv[J]. Nutrition, 1997, 13(5):442-445. doi: 10.1016/S0899-9007(97)91283-1 [8] 赵占吉, 王国良, 李轩, 等.肠内营养在腹部手术后胃瘫治疗中的应用[J].肠外与肠内, 2010, 17(3):166-167. doi: 10.3969/j.issn.1007-810X.2010.03.013Zhao ZJ, Wang GL, Li X, et al. Application of enteral nutrition in the treatment of gastroparesis after abdominal operation[J]. Parenteral & Enteral Nutrition, 2010, 17(3):166-167. doi: 10.3969/j.issn.1007-810X.2010.03.013 [9] 蓝光会, 梁晓燕, 喻军, 等.两种肠内营养管饲途径在远端胃切除BillrothⅠ式吻合术后的疗效[J].广东医学, 2010, 31(8), 1022-1023. doi: 10.3969/j.issn.1001-9448.2010.08.039Lan GH, Liang XY, Yu J, et al. The effect of two different enteral tube feeding way in the distal gastrectomy with Billrot h Ianastomosis[J]. Guangdong Medical Journal, 2010, 31(8):1022-1023. doi: 10.3969/j.issn.1001-9448.2010.08.039 [10] 朱新华, 仇毓东, 吴亚夫, 等.三腔胃肠管在胰十二指肠切除术后行早期肠内营养的应用价值[J].世界华人消化杂志, 2010, 18(28):3026-3030. http://www.cqvip.com/QK/71135X/201107/36034901.htmlZhu XH, Chou YD, Wu YF, et al. Value of early enteral nutrition through Freka Trelumina in patients after pancreaticoduodenectomy [J]. World Chinese Journal of Digestology, 2010, 18(28):3026-3030. http://www.cqvip.com/QK/71135X/201107/36034901.html [11] 赵玉洲, 韩广森, 马鹏飞, 等.胰十二指肠切除术中经胃造口管放置空肠营养管的临床研究[J].肠外与肠内营养, 2012, 19(1):12-15. doi: 10.3969/j.issn.1007-810X.2012.01.004Zhao YZ, Han GS, Ma PF, et al. Clinical application of placement of jejunal feeding tube through gastrostomy tube in pancreaticoduodenectomy[J]. Parenteral & Enteral Nutrition, 2012, 19(1):12-15. doi: 10.3969/j.issn.1007-810X.2012.01.004 [12] 欧扬, 李玉民, 杨丽萍, 等.胆肠吻合术中空肠盲襻造瘘行肠内营养的临床应用[J].中国普外基础与临床杂志, 2008, 15(11):811-812. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgpwjcylczz200811005Ou Y, Li YM, Yang LP, et al. Clinical practice of enteral nutrition with jejunum stoma in choledochojejunostomy[J]. Chin J Bases Clin General Surg, 2008, 15(11):811-812. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgpwjcylczz200811005 [13] 李月春, 王东霞, 胡夏荣, 等.结直肠癌术后早期肠内营养的应用体会[J].中国普外基础与临床杂志, 2008, 15(8):609-611. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgpwjcylczz200808017Li YC, Wang DX, Hu XR, et al. Clinical application of early postoperative enteral nutrition after colorectalectomy[J]. Chin J Bases Clin General Surg, 2008, 15(8):609-611. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgpwjcylczz200808017 [14] Joos AK, Palma P, Jonescheit JO, et al. Enteral vs parenteral nutrition in reconstructive anal surgery-a prospective-randomized trial [J]. Colorectal Dis, 2008, 10(6):605-609. doi: 10.1111/j.1463-1318.2007.01403.x [15] Wang XY, Zhang P, Wu GH, et al. Enteral Nutrition Improves Clinical Outcome and Shortens Hospital Stay After Cancer Surgery [J]. J Invest Surg, 2010, 23(6):309-313. doi: 10.3109/08941939.2010.519428 [16] Liu H, Ling W, Shen ZY, et al. Clinical application of immune-enhanced enteral nutrition in patients with advanced gastric cancer after total gastrectomy[J]. J Dig Dis, 2012, 13(8):401-406. doi: 10.1111/j.1751-2980.2012.00596.x [17] Zhao HY, Zhao HY, Wang Y. Randomized clinical trial of arginine-supplemented enteral nutrition versus standard enteral nutrition in patients undergoing gastric cancer surgery[J]. J Cancer Res Clin Oncol, 2013, 139(9):1465-1470. doi: 10.1007/s00432-013-1466-5 [18] 邵峰, 杨成刚, 刘鑫, 等.免疫微生态肠内营养在合并糖尿病的胃肠道肿瘤患者中的应用[J].中华胃肠外科杂志, 2012, 15(5):476-479. doi: 10.3760/cma.j.issn.1671-0274.2012.05.019Shao F, Yang CG, Liu X, et al. Application of microbiological and immunological enteral nutrition in patients with gastrointestinal cancer complicated with diabetes mellitus[J]. Chinese Journal of Gastrointestinal Surgery, 2012, 15(5):476-479. doi: 10.3760/cma.j.issn.1671-0274.2012.05.019 [19] Nakao M, Ogura Y, Satake S, et al. Usefulness of soluble dietary fiber for the treatment of diarrhea during enteral nutrition in elderly patients[J]. Nutrition, 2002, 18(1):35-39. doi: 10.1016/S0899-9007(01)00715-8 [20] 宋茂力, 邹小明, 李晓林.全胃切除术后应用不同营养制剂进行肠内营养58例[J].世界华人消化杂志, 2009, 17(21):2195-2197. doi: 10.3969/j.issn.1009-3079.2009.21.015Song ML, Zou Xm, li XL. Enteral nutrition in patients after total gastrectomy: an analysis of 58 cases[J]. World Chinese Journal of Digestology, 2009, 17(21):2195-2197. doi: 10.3969/j.issn.1009-3079.2009.21.015 [21] 黄尧, 胡青钢, 杨念印, 等.肠内免疫营养在恶性梗阻性黄疸患者术后的临床应用[J].肠外与肠内营养, 2004, 11(4): 205-208. doi: 10.3969/j.issn.1007-810X.2004.04.005Huang R, Hu QG, Yang NY, et al. The cl inical appl ication of immune enteral nutrition support to malignant obstructive jaundice patients af ter operation[J]. Parenteral & Enteral Nutrition, 2004, 11(4): 205-208. doi: 10.3969/j.issn.1007-810X.2004.04.005 [22] 赵明利, 薛琪, 李雅男, 等.腹腔镜结肠癌术后早期口服肠内营养的临床观察[J].中华胃肠外科杂志, 2013, 16(11):1041-1044. doi: 10.3760/cma.j.issn.1671-0274.2013.11.006Zhao ML, Xue Q, Li YN, et al. Clinical observation of early oral enteral nutrition after laparoscopic colectomy[J]. Chinese Journal of Gastrointestinal Surgery, 2013, 16(11):1041-1044. doi: 10.3760/cma.j.issn.1671-0274.2013.11.006 [23] van Berge Henegouwen MI, Akkermans LM, van Gulik TM, et al. Prospective, Randomized Trial on the Effect of Cyclic Versus Continuous Enteral Nutrition on Postoperative Gastric Function After Pylorus-Preserving Pancreatoduodenectomy[J]. Ann Surg, 1997, 226(6):677-685. doi: 10.1097/00000658-199712000-00005 [24] Martignoni ME, Friess H, Sell F, et al. Enteral Nutrition Prolongs Delayed Gastric Emptying in Patients after Whipple Resection[J]. Am J Surg, 2000, 180(1):18-23. doi: 10.1016/S0002-9610(00)00418-9 [25] Tien YW, Yang CY, Wu YM, et al. Enteral Nutrition and Biliopancreatic Diversion Effectively Minimize Impacts of Gastroparesis After Pancreaticoduodenectomy[J]. J Gastrointest Surg, 2009, 13(5): 929-937. doi: 10.1007/s11605-009-0831-9 [26] Rayar M, Sulpice L, Meunier B, et al. Enteral Nutrition Reduces Delayed Gastric Emptying After Standard Pancreaticoduodenectomy with Child Reconstruction[J]. J Gastrointest Surg, 2012, 16(5):1004-1011. doi: 10.1007/s11605-012-1821-x [27] Portanova M. Successful enteral nutrition in the treatment of esophagojejunal fistula after total gastrectomy in gastric cancer patients[J]. World J Surg Oncol, 2010, 8:71. doi: 10.1186/1477-7819-8-71 [28] Akashi Y, Hiki N, Nunobe S, et al. Safe management of anastomotic leakage after gastric cancersurgery with enteral nutrition via a nasointestinal tube[J]. Langenbecks Arch Surg, 2012, 397(5):737-744. doi: 10.1007/s00423-012-0935-7
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