Methods Sixty-six postoperative patients with gastric cancer combined diabetes were divided into 3 groups according to the balanced principle. In the frist group (FD group), FD was the nutrition preparation for 21 patients. In the second group (fresubin group), fresubin and the ordinary insulin injection were the nutrition preparation for 21 patients. In the third group (TPN group), the nutrition preparation came from TPN and the ordinary insulin injection for 24 patients. FD, fresubin or TPN were given at 24 h after operation, the levels of blood glucose for empty stomach, after meal (enteral nutrition or TPN) and the common complications compared among 3 groups of postoperative patients. Results ① In FD group, the levels of blood glucose of postoperative empty stomach and after enteral nutrition were stable with little fluctuation and no insulin was needed with 1 case of hyperglycemia (4.8%). In fresubin group and TPN group, the levels of blood glucose of postoperative empty stomach and after enteral nutrition or TPN were unstable with big fluctuation, with 6 cases (28.6%) and 8 cases (33.3%) of hyperglycemia, 5 cases (23.8%) and 6 cases (25.0%) of hypoglycemia in fresubin group and TPN group, respectively. Compared with fresubin group and TPN group, the rate of pathoglycemia was lower in FD group, the difference had statistical significance separately (Plt;0.05); There was no significant difference between fresubin group and TPN group (Pgt;0.05). ② The rates of infection of incisional wound in FD group (4.8%) and fresubin group (23.8%) were lower than that of TPN group (33.3%), there was significant difference among 3 groups (Plt;0.05); The time of passage of gas by anus in FD group and fresubin group were shorter than that in TPN group (Plt;0.05); There was no significant difference between FD group and fresubin group (Pgt;0.05). There were no significant differences of the rates of abdominal distension or diarrhea among 3 groups (Pgt;0.05). Conclusion Regarding postoperative patients with gastric cancer combined diabetes, in the early time field test group of the nutrition preparation, FD is better than fresubin or TPN, which does not increase the risk of the blood glucose change and have few complications.
【Abstract】ObjectiveTo investigate the effects of rhGH on hypoalbuminemia in cirrhotic rats after partial hepatectomy. MethodsThirty rats were randomly divided into normal control group (n=6), liver cirrhosis group (LC group, n=6), liver cirrhosis and hepatectomy group (LCH group,n=6), PN (parenteral nutrition) group (n=6， given PN after hepatectomy) and rhGH+PN group (n=6,given rhGH and PN after hepatectomy). Liver function and blood glucose were measured. The expression of ALB mRNA was detected by RTPCR. Liver Ki67 immunohistochemistry was studied. ResultsCompared with PN group, serum ALP was lower; serum ALB and blood glucose were higher in rhGH+PN group. The expression of hepatic ALB mRNA was higher, and hepatic Ki67 labeling index was higher as well in this group. ConclusionrhGH can improve hypoalbuminemia after partial hepatectomy in cirrhotic rats with partial hepatectomy.
Objective To study the manageable methods, effect of early use of enteral nutrition after operations on esophageal cancer patients. Methods By different way of nutritional support after operation, 209 cases of esophageal cancer were divided into two groups in which enteral nutrition（EN） group,146 cases, were managed with early use of nutritional support through intestine and parenteral nutrition（PN） group, 63 cases, were given nutrition by way of veins. Complications, general recovery and blood biochemical criteria after operation between those two groups were compared. Results No cases of anastomotic fistula occurred in the two groups. The incidence of complications in EN group was significantly lower than that in PN group（P〈0.01）, and the occurrence of diarrhea was higher in EN group （P=0. 000）. The time needed for recovery of bowel sounds, anal exsufflation, defecation and hospital stay was shorter and hospital fee lower in EN group than those in PN group（P=0. 000）. The total amount of gastrointestinal and closed thoracic drainages decreased more significantly in EN group （P= 0. 000） and the value of albumin, globulin and total protein was significantly higher also in EN group （P = 0. 000）. But the amount of BUN, creatinine and neutrophil was significantly lower in EN group （P = 0. 000）. Conclusion Early use of enteral nutrition after operation on esophageal cancer is safe, effective and practical, with more significant advantages than those of parenteral nutrition.
In order to investigater the effect of nutritional support on nutrients metabolism after liver resection,we researched into the hepatectomy and total parenteral nutrition model in rats.The features of the model were no fasting before surgery,10% glucose subcutaneous injection prior to operation avoiding of blood loss and shortening of the surgical process.The 7-day mortality was markedly decreased.Anesthetized with phenobarbital(25mg/kg) injection in combination of ether inhalation,the rats recovered quickly from anesthesia and developed almost no infection of the respiratory tract after hepatectomy.The rats were supplied parenterally energy of 573kJ/kg and a marked improvement in survival was achieved after liver resection.By applying dual preventive rotation equipment of protective spring and IN-Stopper,nutrient solution could be safely infused.
Objective To research the effect of ω-3 polyunsaturated fatty acid (PUFA) on promoting the postoperative rehabilitation of patients with gastrointestinal malignancies in order to decrease the incidence of postoperative complications and the days of postoperative hospital stay. Methods Forty patients with gastrointestinal malignancies in West China Hospital of Sichuan University from February 1st, 2009 to June 1st, 2009 were included and allocated to experimental group (20 cases) and control group (20 cases) randomly. Seven days parenteral nutrition was provided to them after operation. Compared with control group, ω-3 PUFA with a dose of 10 g was given to experimental group every day additionally. Blood samples were gained before operation, on the morning of day 2 and day 8 after operation respectively to measure hepatorenal and immune indexes. Temperature before and 1-7 d after operation, time of passing flatus to normal, postoperative complications and the postoperative hospital stay were recorded. Results There was no statistical difference in the baselines between experimental group and control group （Pgt;0.05）. The level of total bilirubin in experimental group was lower and the levels of NK cell and B cell in experimental group were higher than those in control group on day 2 after operation, there were statistical differences between them (Plt;0.05). The levels of ALT, AST and blood urea mitrogen in experimental group were lower and the levels of CD4+ cell and NK cell in experimental group were higher than those in control group on day 8 after operation, there were statistical differences between them, too (Plt;0.05). The time of passing flatus to normal and days of staying in hospital after operation in experimental group were shorter than those in control group, there were statistical differences between them (Plt;0.05). There was no statistical difference in postoperative average temperature and incidence of complications between two groups （Pgt;0.05）. Conclusions ω-3 PUFA has positive influence on the recovery of hepatorenal, immune and gastrointestinal function, and can shorten the days of postoperative hospital stay; but there is no effect on incidence of complications after operation.
ObjectiveTo investigate the clinical advantages of enteral nutrition (EN) for acute pancreatitis（AP）comparing with parenteral nutrition (PN) and its prospect. MethodsLiteratures using MESH Browser in Medline were collected and reviewed. ResultsBeing of much higher cost and complications, total parenteral nutrition (TPN) ever regarded as most importantly for AP nutritional support, is now challenged by EN. Clinical evidence suggests enteral (jejunal) nutrition may diminish intestinal permeability to endotoxin and diminish bacterial translocation, thus reducing the cytokine drive to the generalized inflammatory response and preventing organ dysfunction, as well as achieving “pancreatic rest” equivalent to the TPN. Conclusion Early enteral nutrition should be used preferentially for patients with severe acute pancreatitis without paralytic ileus.
ObjectiveTo investigate the effects of total parenteral nutrition in neonatal patients and study the nursing methods for these neonates. MethodsWe retrospectively analyzed the clinical data of 70 neonatal patients who accepted total parenteral nutrition in our hospital from October 2010 to October 2011. Physiological indexes were compared before and after total parenteral nutrition. ResultsSignificant improvements in the nutritional status of all children were observed. All patients achieved good efficacy and effective care. ConclusionTotal parenteral nutrition support for critically ill newborns is of great significance, and good caring also plays an important role.
ObjectiveTo research and summarize the best evidences of probiotic-riched early enteral nutrition for postoperative liver transplantation, and provide references for precise and individual clinical nutrition and probiotics usage management in patients with liver transplantation.MethodsThe scientific problem was established according to the PIPOST. The British Medical Journal Best Practice, Cochrane Library, Jonna Briggs Institute, Guidelines International Network, National Guideline Clearinghouse, etc. were used to search the papers or relative data recordings. The evidence evaluation and summary were carried out based on the previous documents.ResultsOne evidence summary, 2 systematic reviews, and 5 randomized controlled studies were included. Based on the specific questions, 6 dimensions (24 evidences) were extracted and summarized: the early enteral nutrition was used within postoperative 24 h, starting with 20 mL/h, but not more than 125 mL/h, essential nutrients would be fine and tube feeding would be converted to oral feeding as soon as possible; Lactobacillus 20 mg and Bifidobacterium 15 mg were suggested, 3 times/d, probiotic-riched early enteral nutrition for postoperative liver transplantation should be lasted for at least 14 d.ConclusionsEvidence-based medicine is used to collect the best evidence of probiotic-riched early enteral nutrition for postoperative liver transplantation, there are few studies on early enteral nutrition after liver transplantation in China. Application of the best evidence needs to be analyzed and constructed according to current situation of liver transplantation in China.
Objective To promote the clinical application of parenteral and enteral nutrition preparations in hospitalized patients. Methods Domestic and foreign articles about parenteral and enteral nutrition support were enrolled to make a review. Results Nowadays, parenteral and enteral nutrition played an important role in the medical treatment of perioperative and critically ill patients. Rational nutrition support could improve the condition of patients with nutritional risk and result in better clinical outcomes. Different enteral nutrition formulations should be used according to the diseases. Supplementally parenteral nutrition may also be useful in combination with enteral nutrition to reach the required intake targets. We should pay attention to the application of glucose, lipid emulsion, amino acids, vitamins, and so on, when performed parenteral nutrition support. Conclusion It is necessary to standardize parenteral and enteral nutrition support in the work of clinical practice, including the application of nutrition support and selection of nutrition preparations.
ObjectiveTo explore clinical effect of enteral nutrition (EN) through nasojejunal tube in severe acute pancreatitis (SAP).MethodsThe clinical and pathological data of 76 patients with SAP who met the inclusion criteria and treated in the Third People’s Hospital of Henan Province from June 2015 to December 2018 were retrospectively collected. According to the nutritional support therapy adopted in the course of treatment, the patients were divided into an EN group (n=44) and a parenteral nutrition group (PN group, n=32), the patients in the EN group were given the EN through the nasojejunal tube and the patients in the PN group were given the routine PN. The APACHE Ⅱ and SOFA scores, nutritional status, and immune function were observed before the treatment and on week 2 after the treatment in the two groups.ResultsThere were no significant differences in the general data of the gender, age, body mass index, etc. between the two groups (P>0.050). ① The score of APACHEⅡ or SOFA score on week 2 after the treatment in both groups was significantly lower than that before the treatment (P<0.050), which in the EN group was significantly lower than that in the PN group on week 2 after the treatment (P<0.050). ② The levels of albumin and prealbumin were increased significantly and the hemoglobin level was decreased (P<0.050) on week 2 after the treatment as compared with those before the treatment in the two groups (P<0.050), which in the EN group were significantly higher than those in the PN group on week 2 after the treatment (P<0.050). ③ The CD4, CD8, and CD4/CD8 and IgG, IgM, and IgA on week 2 after the treatment were significantly lower than those before the treatment in these two groups (P<0.050), which in the EN group were significantly higher than those in the PN group on week 2 after the treatment (P<0.050). ④ The levels of endotoxin, D-lactic acid, diamine oxidase, and serum high mobility group protein B1 on week 2 after the treatment were significantly lower than those before the treatment in the two groups (P<0.050), and which in the EN group were significantly lower than those of the PN group on week 2 after the treatment (P<0.050). ⑤ The complications rate in the EN group was significantly lower than that in the PN group [20.45% (9/44) versus 53.13% (17/32), χ2=8.786, P=0.003].ConclusionEN through nasojejunal tube has a good effect on patients with SAP, which is helpful to improve their immune and nutritional status.