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胃肠道吻合术后早期与晚期肠内营养的比较研究

A Comparative Study Between the Early and Late Enteral Nutrition After Gastrointestinal Anastomosis Operations.

作者信息

Imran Asif, Ismail Muhammad, Raza Abbas Ali, Gul Tamjeed, Khan Aurangzeb, Shah Saad Ali

机构信息

Surgery, Bacha Khan Medical College, Mardan, PAK.

General Surgery, Bacha Khan Medical College, Mardan, PAK.

出版信息

Cureus. 2024 Jan 21;16(1):e52686. doi: 10.7759/cureus.52686. eCollection 2024 Jan.

Abstract

INTRODUCTION

Intestinal anastomosis is a surgical procedure crucial for restoring the integrity of the digestive system and finds widespread application in addressing diverse gastrointestinal disorders such as tumors, inflammatory conditions, and traumatic injuries. The timing of restarting feeding after the surgery is a debated topic due to its potential impact on patient recovery. Early enteral feeding, administered soon after surgery, aims to counteract the negative effects of prolonged fasting and improve outcomes.

OBJECTIVE

This study analyzed the early and late enteral feeding following gastrointestinal anastomosis surgery.

METHODS

Forty patients undergoing abdominal surgery were prospectively randomized into early or late feeding groups. Demographics, laboratory values, operative time, blood loss, transfusion rates, nasogastric tube (NGT) removal, hospital stay, gastrointestinal recovery, postoperative body mass index (BMI), and complications were compared. Data was organized in Excel and analyzed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 27.0, Armonk, NY). Qualitative data were presented with numbers and percentages, while parametric quantitative data used means, standard deviations, and ranges. Non-parametric quantitative data were represented with medians and interquartile ranges. Chi-square tests were used for comparing two qualitative groups with predicted counts less than 5, while independent t-tests and Mann-Whitney tests were employed for comparing two quantitative groups with parametric and non-parametric distributions, respectively. The analysis used a 95% confidence interval, a 5% margin of error, and considered P values less than 0.05 as significant.

RESULTS

Early feeding was associated with significantly shorter NGT removal times (p=0.005) and hospital stays (p=0.001) than late feeding. Postprandial potassium levels were higher in the early group (p=0.007), while CRP levels were significantly lower (p=0.004). No significant differences were found in operative time, blood loss, transfusion rates, gastrointestinal recovery, postoperative BMI, or complication rates between groups.

CONCLUSIONS

Early enteral feeding appears safe and effective after gastrointestinal anastomosis surgery, potentially reducing hospital stay and improving inflammatory markers without increasing adverse events.

摘要

引言

肠道吻合术是恢复消化系统完整性的关键外科手术,在治疗多种胃肠道疾病(如肿瘤、炎症性疾病和创伤性损伤)中有着广泛应用。由于手术重启进食时间对患者恢复有潜在影响,因此这是一个存在争议的话题。术后早期肠内营养即在手术后不久进行,旨在抵消长时间禁食的负面影响并改善治疗效果。

目的

本研究分析了胃肠道吻合术后的早期和晚期肠内营养情况。

方法

40例行腹部手术的患者被前瞻性随机分为早期或晚期进食组。比较了两组患者的人口统计学数据、实验室检查值、手术时间、失血量、输血率、鼻胃管拔除情况、住院时间、胃肠道恢复情况、术后体重指数(BMI)及并发症。数据整理在Excel中,并使用社会科学统计软件包(IBM SPSS Statistics for Windows,IBM公司,版本27.0,纽约州阿蒙克)进行分析。定性数据用数字和百分比表示,参数定量数据用均值、标准差和范围表示。非参数定量数据用中位数和四分位间距表示。卡方检验用于比较两个预期频数小于5的定性组,而独立t检验和曼-惠特尼检验分别用于比较两个具有参数分布和非参数分布的定量组。分析采用95%置信区间、5%误差幅度,P值小于0.05被视为具有统计学意义。

结果

与晚期进食相比,早期进食组的鼻胃管拔除时间(p = 0.005)和住院时间(p = 0.001)显著缩短。早期组餐后血钾水平较高(p = 0.007),而CRP水平显著较低(p = 0.004)。两组在手术时间、失血量、输血率、胃肠道恢复情况、术后BMI或并发症发生率方面未发现显著差异。

结论

胃肠道吻合术后早期肠内营养似乎安全有效,可能缩短住院时间并改善炎症指标,且不增加不良事件。

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