Beier-Holgersen R, Boesby S
Department of Surgical Gastroenterology D, Glostrup, Denmark.
Gut. 1996 Dec;39(6):833-5. doi: 10.1136/gut.39.6.833.
This study was undertaken to test the hypothesis that early enteral nutrition might reduce the incidence of serious complications after major abdominal surgery.
In a randomised double blind prospective trial 30 patients received Nutri-drink and 30 patients received placebo through a nasoduodenal feeding tube. On the day of operation the patients were given median 600 ml of either nutrition or placebo, 60 ml per hour. On the first postoperative day the patients received either 1000 ml (median) of nutrition or placebo, on day 2 1200 ml (median) nutrition, 1400 ml placebo, on day 3 1000 ml (median) nutrition, 1150 ml placebo, and on day 4 1000 ml (median) nutrition, 800 ml placebo. All patients were followed up for 30 days by the same investigator.
The two groups were similar with regard to nutritional status and type of operation. The rate of postoperative infectious complications was significantly lower in the nutrition group, two of 30 compared with 14 of 30 in the placebo group (p = 0.0009).
Early enteral nutrition given to patients after major abdominal surgery results in an important reduction in infectious complications.
本研究旨在验证早期肠内营养可能降低腹部大手术后严重并发症发生率这一假说。
在一项随机双盲前瞻性试验中，30例患者通过鼻十二指肠喂养管接受营养饮料，30例患者接受安慰剂。手术当天，患者接受中位数为600毫升的营养物或安慰剂，每小时60毫升。术后第一天，患者接受中位数为1000毫升的营养物或安慰剂，第二天接受1200毫升（中位数）营养物、1400毫升安慰剂，第三天接受1000毫升（中位数）营养物、1150毫升安慰剂，第四天接受1000毫升（中位数）营养物、800毫升安慰剂。所有患者均由同一名研究者随访30天。
两组在营养状况和手术类型方面相似。营养组术后感染并发症发生率显著较低，30例中有2例，而安慰剂组30例中有14例（p = 0.0009）。
腹部大手术后给予患者早期肠内营养可显著降低感染并发症的发生率。
