Salsi P, Cortellini P, Simonazzi M, Ferretti S, Soliani P, Dell'Abate P, Foggi E
Divisione di Urologia, Azienda Ospedaliera di Parma.
Acta Biomed Ateneo Parmense. 1998;69(1-2):61-5.
To evaluate the efficacy of early enteral nutrition in management of patients operated by major urologic surgery and to demonstrate her advantages versus total parenteral nutrition.
20 patients, operated by radical cystectomy and urinary diversion by ureteroileocutaneostomy, Padua ileal bladder or ureterosigmoidostomy are inserted in our study: 12 were treated by early enteral nutrition for 8 days and eight by total parenteral nutrition for the same period: in each group nutritional and immunological parameters at day -1, +3 and +7, the length of postoperatory stay, the incidence of complications, with particular respect for infections have been evaluated and correlated one to each other.
We have no death in each group; in the first group no gastroenteric allergy to the nutrient, less incidence of venous catheter and surgical wound infections (respectively p < 0.01 and p < 0.005); we have no significant decrease of postoperatory stay length; the effective problem in this group was the incidence of diarrhea, that in one case have made necessary the suspension of enteral nutrition. Enteral nutrition costs were about half of those of total parenteral nutrition.
We believe that early enteral nutrition is an effective and safe nutrition method in patients operated by major urologic surgery: with this is possible a better nutrition, that reduce the incidence of postoperative complications, mainly infections, and maybe the length of postoperatory stay (our champion is too small for statistical evaluation), that may lead to a decrease in management costs of these patients.
评估早期肠内营养在泌尿外科大手术患者管理中的疗效，并证明其相对于全肠外营养的优势。
20例行根治性膀胱切除术并采用输尿管回肠皮肤造口术、帕多瓦回肠膀胱术或输尿管乙状结肠吻合术进行尿流改道的患者纳入本研究：12例接受早期肠内营养治疗8天，8例在同一时期接受全肠外营养治疗：评估每组在第-1天、+3天和+7天的营养和免疫参数、术后住院时间、并发症发生率，尤其关注感染情况，并相互关联。
每组均无死亡病例；第一组对营养物质无胃肠道过敏反应，静脉导管和手术伤口感染发生率较低（分别为p<0.01和p<0.005）；术后住院时间无显著缩短；该组的有效问题是腹泻发生率，有1例患者因此不得不暂停肠内营养。肠内营养费用约为全肠外营养的一半。
我们认为早期肠内营养是泌尿外科大手术患者一种有效且安全的营养方法：通过这种方法可以实现更好的营养状况，降低术后并发症的发生率，主要是感染，并且可能缩短术后住院时间（我们的样本量太小，无法进行统计学评估），这可能导致这些患者的管理成本降低。
