Hyat Inurrieta L, Pérez Contín M J, Mayol Martínez J, Díaz González J, Blas Layna J L, Alvarez Fernández-Represa J
I Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario San Carlos, Madrid, España.
Nutr Hosp. 1995 May-Jun;10(3):177-80.
The results of an enteral nutritional pattern used in 40 seriously ill patients who underwent gastrointestinal tract surgery, are described. The most frequently used route of administration (97.5% of the cases) was a jejunal catheter. We review the types of formula used, the method and time of perfusion, and the association with parenteral nutrition. The mean time of perfusion was 8.6 (5) days and the morbidity rate due to enteral nutrition was 20%. In all cases the complications were minor (externalization of the catheter in 2 cases, proximal reflux of the formula in 1 patient, a catheter break, which was eliminated through the stool without any consequences, in 1 case, diarrhoea in 2 patients, and catheter obstruction in 2 cases). The nutritional results, evaluated by means of clinical chemistry (total proteins, albumin, prealbumin, and transferrin), showed a stabilization of the catabolic process in patients with a poor preoperative nutritional state under severe surgical stress. It can be concluded that enteral nutrition is a useful manner of postoperative feeding in seriously ill patients who undergo gastrointestinal surgery, and that it must often be added to parenteral nutrition to ensure an adequate caloric intake.
本文描述了对40例接受胃肠道手术的重症患者采用肠内营养模式的结果。最常用的给药途径(97.5%的病例)是空肠导管。我们回顾了所用配方的类型、灌注方法和时间,以及与肠外营养的联合使用情况。平均灌注时间为8.6(5)天,肠内营养导致的发病率为20%。所有病例的并发症均较轻微(2例导管外露,1例患者配方近端反流,1例导管断裂,粪便排出后无任何后果,2例腹泻,2例导管阻塞)。通过临床化学(总蛋白、白蛋白、前白蛋白和转铁蛋白)评估的营养结果显示,在严重手术应激下术前营养状态较差的患者中,分解代谢过程得到了稳定。可以得出结论,肠内营养是接受胃肠道手术的重症患者术后喂养的一种有用方式,并且通常必须添加到肠外营养中以确保足够的热量摄入。