Effect of Early Enteral Nutrition on Postoperative Nutritional Status and Clinical Outcomes of Patients with Upper Digestive Tract Ulcer Perforation after Operation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 FENGBin , ZHUQing , BAIMei-ying , LIULi-xia ,  SIShi-tong

Department of Gastrointestinal Surgery, Heze Municiple Hospital, Heze 274000, Shandong Province, China;

Corresponding author：

SIShi-tong, Email: sishitong@126.com

Keywords：

Upper digestive tract ulcer perforation; Emergency operation; Early enteral nutrition; Nutritional status; Clinical prognosis

DOI：

10.7507/1007-9424.20150318

Video：

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Objective To investigate the effect of enteral nutrition support on postoperative nutritional status and clinical outcomes in patients with upper digestive tract ulcer perforation. Methods Seventy-twe patients with upper gastrointestinal ulcer perforation who treated in Heze Municipal Hospital from 2012 to 2014 were randomly divided into early enteral nutrition (EEN) group (n=36) and parenteral nutrition (TPN)group (n=36) according to their different ways of nutrition, the body weight, body mass index, the levels of prealbumin and albumin before operation and on day 7 ofter operation were analyzed. The time of resumption of gastrointestinal function, the time of hospital stay, hospitalization cost, and postoperative complication were recorded. Results There were no significant differences on levels of body weight, body mass index, serum albumin, and prealbumin before operation between the 2 groups (P > 0.05). On day 7 after operation, the levels of body weight, body mass index, prealbumin, and albumin were significantly low in both groups, and the TPN group was decreased more than EEN group (P < 0.05). The inffect complications in EEN group was lower than in TPN group, the time of resumption of gastrointestinal function in EEN group was shorter than in TPN group, and the hospital stay and hospitalization cost in EEN group were both lower than in TPN group, there were significant difference between the 2 groups (P < 0.05). Conclusions Early postoperative enteral nutrition for the patients with upper gastrointestinal ulcer perforation after operation can be effective to improve the nutrition status, reduce the incidence of infectious complications, promote early recovery of gastrointestinal function, reduce hospitalization cost, and accelerate the rehabilitation of patients.

Citation： FENGBin, ZHUQing, BAIMei-ying, LIULi-xia, SIShi-tong. Effect of Early Enteral Nutrition on Postoperative Nutritional Status and Clinical Outcomes of Patients with Upper Digestive Tract Ulcer Perforation after Operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(10): 1230-1234. doi: 10.7507/1007-9424.20150318 Copy

1.	杨海健.老年上消化道穿孔的临床特点与外科治疗.吉林医学, 2010, 31(30):5355.
2.	李凤景, 杨晓丽PICC在老年患者静脉营养中的应用.河北医药, 2010, 32(24):3576-3577.
3.	Kaur N, Gupta MK, Minocha VR. Early enteral feeding by nasoenteric tubes in patients with perforation peritonitis. World J Surg, 2005, 29(8):1023-1028.
4.	Malhotra A, Mathur AK, Gupta S. Early enteral nutrition after surgical treatment of gut perforations:a prospective randomised study. J Postgrad Med, 2004, 50(2):102-106.
5.	Singh G, Ram RP, Khanna SK. Early postoperative enteral feeding in patients with nontraumatic intestinal perforation and peritonitis. J Am Coll Surg, 1998, 187(2):142-146.
6.	Guillaume A, Seres DS. Safety of enteral feeding in patients with open abdomen, upper gastrointestinal bleed, and perforation peritonitis. Nutr Clin Pract, 2012, 27(4):513-520.
7.	华晨, 刘励军早期肠内营养在危重症病人营养支持中的临床价值.肠外与肠内营养, 2011, 2(1):641-643.
8.	吴肇汉.努力提高我国的临床营养的整体水平.中华胃肠外科杂志, 2012, 15(5):426-428.
9.	Lewis SJ, Egger M, Sylvester PA, et al. Early enteral feeding versus "nil by mouth" after gastrointestinal surgery:systematic review and meta-analysis of controlled trials. BMJ, 2001, 323(7316):773-776.
10.	陈玉民.肠内营养在术后早期的应用.中国临床营养杂志, 2003, 11(3):216-218.
11.	宋延强, 吕文平, 庞新建.老年胃癌患者术后早期肠内营养与肠外营养疗效的比较.中华普通外科杂志, 2004, 19(2):97-99.
12.	秦新裕, 刘寒.肠内营养与胃肠动力.中国实用外科杂志, 2003, 23(2):81-83.
13.	Guglielmi FW, Boggio-Bertinet D, Federico A, et al. Totalparenteral nutrition-related gastroenterological complications. Dig Liver Dis, 2006, 38(9):623-642.
14.	Lee HS, Shim H, Jang JY, et al. Early feeding is feasible after emergency gastrointestinal surgery. Yonsei Med J. 2014, 55(2):395-400.
15.	Kuwabara Y, Takeyama H. Nutritional support to prevent infectious complications after surgery. Nihon Geka Gakkai Zasshi, 2010, 111(6):348-352.
16.	Mazuski JE. Feeding the injuerd intestine:enteral nutrition the critically ill patient. Curr Opin Crit Care, 2008, 14(4):432-437.
17.	赵桂彬, 曹守强, 张凯, 等.早期肠内营养对食管癌患者术后免疫功能和临床结局的影响.中华胃肠外科杂志, 2014, 4(17):356-360.
18.	Osland E, Yunus RM, Khan S, et al. Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery:a meta-analysis. JPEN J Parenter Enteral Nutr, 2011, 35(4):473-487.
19.	Azuma H, Mishima S, Oda J, et al. Enteral supplementation en riched with glutamine, fiber, and oligosaccharide prevents gut translocation in abacterial overgrowth model. J Trauma, 2009, 66(1):110-114.
20.	Pupelis G, Selga G, Austrums E, et al. Jejunal feeding, even when instituted late, improves outcomes in patients with severe pancreatitis and peritonitis. Nutrition, 2001, 17(2):91-94.
21.	Wereszczynska-Siemiatkowska U, Swidnicka-Siergiejko A, Siemiatkowski A, et al. Early enteral nutrition is superior to delayed enteral nutrition for the prevention of infected necrosis and mortality in acute pancreatitis. Pancreas, 2013, 42(4):640-646.
22.	Elke G, Heyland DK. Enteral nutrition in critically ill septic patientsless or more? JPEN J Parenter Enteral Nutr, 2015, 39(2):140-142.
23.	Elke G, Wang M, Weiler N, et al. Close to recommended caloric and protein intake by enteral nutrition is associated with better clinical outcome of critically ill septic patients:secondary analysis of a large international nutrition database. Crit Care, 2014, 18(1):R29.
24.	Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreat-icoduodenectomy:Enhanced Recovery After Surgery (ERAS) Society recommendations. Clin Nutr, 2012, 31(6):817-830.
25.	冯立, 王峰.胃癌患者根治术后早期肠内营养的临床观察.中国普外基础与临床杂志, 2014, 21(3):325-329.

1. 杨海健.老年上消化道穿孔的临床特点与外科治疗.吉林医学, 2010, 31(30):5355.
2. 李凤景, 杨晓丽PICC在老年患者静脉营养中的应用.河北医药, 2010, 32(24):3576-3577.
3. Kaur N, Gupta MK, Minocha VR. Early enteral feeding by nasoenteric tubes in patients with perforation peritonitis. World J Surg, 2005, 29(8):1023-1028.
4. Malhotra A, Mathur AK, Gupta S. Early enteral nutrition after surgical treatment of gut perforations:a prospective randomised study. J Postgrad Med, 2004, 50(2):102-106.
5. Singh G, Ram RP, Khanna SK. Early postoperative enteral feeding in patients with nontraumatic intestinal perforation and peritonitis. J Am Coll Surg, 1998, 187(2):142-146.
6. Guillaume A, Seres DS. Safety of enteral feeding in patients with open abdomen, upper gastrointestinal bleed, and perforation peritonitis. Nutr Clin Pract, 2012, 27(4):513-520.
7. 华晨, 刘励军早期肠内营养在危重症病人营养支持中的临床价值.肠外与肠内营养, 2011, 2(1):641-643.
8. 吴肇汉.努力提高我国的临床营养的整体水平.中华胃肠外科杂志, 2012, 15(5):426-428.
9. Lewis SJ, Egger M, Sylvester PA, et al. Early enteral feeding versus "nil by mouth" after gastrointestinal surgery:systematic review and meta-analysis of controlled trials. BMJ, 2001, 323(7316):773-776.
10. 陈玉民.肠内营养在术后早期的应用.中国临床营养杂志, 2003, 11(3):216-218.
11. 宋延强, 吕文平, 庞新建.老年胃癌患者术后早期肠内营养与肠外营养疗效的比较.中华普通外科杂志, 2004, 19(2):97-99.
12. 秦新裕, 刘寒.肠内营养与胃肠动力.中国实用外科杂志, 2003, 23(2):81-83.
13. Guglielmi FW, Boggio-Bertinet D, Federico A, et al. Totalparenteral nutrition-related gastroenterological complications. Dig Liver Dis, 2006, 38(9):623-642.
14. Lee HS, Shim H, Jang JY, et al. Early feeding is feasible after emergency gastrointestinal surgery. Yonsei Med J. 2014, 55(2):395-400.
15. Kuwabara Y, Takeyama H. Nutritional support to prevent infectious complications after surgery. Nihon Geka Gakkai Zasshi, 2010, 111(6):348-352.
16. Mazuski JE. Feeding the injuerd intestine:enteral nutrition the critically ill patient. Curr Opin Crit Care, 2008, 14(4):432-437.
17. 赵桂彬, 曹守强, 张凯, 等.早期肠内营养对食管癌患者术后免疫功能和临床结局的影响.中华胃肠外科杂志, 2014, 4(17):356-360.
18. Osland E, Yunus RM, Khan S, et al. Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery:a meta-analysis. JPEN J Parenter Enteral Nutr, 2011, 35(4):473-487.
19. Azuma H, Mishima S, Oda J, et al. Enteral supplementation en riched with glutamine, fiber, and oligosaccharide prevents gut translocation in abacterial overgrowth model. J Trauma, 2009, 66(1):110-114.
20. Pupelis G, Selga G, Austrums E, et al. Jejunal feeding, even when instituted late, improves outcomes in patients with severe pancreatitis and peritonitis. Nutrition, 2001, 17(2):91-94.
21. Wereszczynska-Siemiatkowska U, Swidnicka-Siergiejko A, Siemiatkowski A, et al. Early enteral nutrition is superior to delayed enteral nutrition for the prevention of infected necrosis and mortality in acute pancreatitis. Pancreas, 2013, 42(4):640-646.
22. Elke G, Heyland DK. Enteral nutrition in critically ill septic patientsless or more? JPEN J Parenter Enteral Nutr, 2015, 39(2):140-142.
23. Elke G, Wang M, Weiler N, et al. Close to recommended caloric and protein intake by enteral nutrition is associated with better clinical outcome of critically ill septic patients:secondary analysis of a large international nutrition database. Crit Care, 2014, 18(1):R29.
24. Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreat-icoduodenectomy:Enhanced Recovery After Surgery (ERAS) Society recommendations. Clin Nutr, 2012, 31(6):817-830.
25. 冯立, 王峰.胃癌患者根治术后早期肠内营养的临床观察.中国普外基础与临床杂志, 2014, 21(3):325-329.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Early Enteral Nutrition on Postoperative Nutritional Status and Clinical Outcomes of Patients with Upper Digestive Tract Ulcer Perforation after Operation

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