李江 1 , 劉斌 1 , 侯宇 2 , 鄭南 1
  • 1.昆明醫(yī)學(xué)院第一附屬醫(yī)院肝膽外科(昆明650032);;
  • 2.昆明醫(yī)學(xué)院第三附屬醫(yī)院放療中心(昆明650118);

目的 探討腹部外科術(shù)后早期腸內(nèi)營(yíng)養(yǎng)（EEN）的臨床研究現(xiàn)狀與應(yīng)用。
方法采用文獻(xiàn)回顧的方法對(duì)EEN的臨床研究現(xiàn)狀與應(yīng)用進(jìn)行綜述。
結(jié)果腹部外科術(shù)后EEN安全、有效，能維護(hù)機(jī)體代謝平衡，保持組織、器官的結(jié)構(gòu)和功能的完整，特別在維護(hù)腸黏膜屏障完整，減少或避免術(shù)后感染性并發(fā)癥方面有一定優(yōu)勢(shì)。
結(jié)論EEN可作為腹部外科術(shù)后患者首選的營(yíng)養(yǎng)支持方式之一。

引用本文： 李江,劉斌,侯宇,鄭南. 腹部外科術(shù)后早期腸內(nèi)營(yíng)養(yǎng)的臨床研究與應(yīng)用. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006, 13(3): 355-357. doi: 復(fù)制

1. Baskin WN. Advances in enteral nutrition techniques [J]. Am J Gastroenterol， 1992; 87(11)∶1547.
2. 胡建昆. 外科術(shù)后早期腸內(nèi)營(yíng)養(yǎng) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2003； 10(4)∶407.
3. Braga M, Gianotti L, Gentilini O, et al. Feeding the gut early after digestive surgery: results of a nineyear experience [J]. Clin Nutr， 2002; 21(1)∶59.
4. 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 [J]. BMJ， 2001; 323(7316)∶773.
5. Brooks AD, Hochwald SN, Heslin MJ, et al. Intestinal permeability after early postoperative enteral nutrition in patients with upper gastrointestinal malignancy [J]. JPEN J Parenter Enteral Nutr， 1999; 23(2)∶75.
6. McCarter MD, Gomez ME, Daly JM. Early postoperative enteral feeding following major upper gastrointestinal surgery [J]. J Gastrointest Surg， 1997; 1(3)∶278.
7. Detry R, Ciccarelli O, Komlan A, et al. Early feeding after colorectal surgery. Preliminary results [J]. Acta Chir Belg， 1999; 99(6)∶292.
8. Pacelli F, Bossola M, Papa V, et al. Enteral vs parenteral nutrition after major abdominal surgery: an even match [J]. Arch Surg， 2001; 136(8)∶933.
9. Braga M, Gianotti L, Gentilini O, et al. Early postoperative enteral nutrition improves gut oxygenation and reduces costs compared with total parenteral nutrition [J]. Crit Care Med， 2001; 29(2)∶242.
10. Gianotti L, Braga M, Gentilini O, et al. Artificial nutrition after pancreaticoduodenectomy [J]. Pancreas， 2000; 21(4)∶344.
11. Stewart BT, Woods RJ, Collopy BT, et al. Early feeding after elective open colorectal resections: a prospective randomized trial [J]. Aust N Z J Surg， 1998; 68(2)∶125.
12. Hsu TC, Leu SC, Su CF, et al. Assessment of intragastric pH value changes after early nasogastric feeding [J]. Nutrition， 2000; 16(9)∶751.
13. Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: a systematic review [J]. Crit Care Med， 2001; 29(12)∶2264.
14. Soliani P, Dell’Abate P, Del Rio P, et al. Early enteral nutrition in patients treated with major surgery of the abdomen and the pelvis [J]. Chir Ital， 2001; 53(5)∶619.
15. Bozzetti F, Braga M, Gianotti L, et al. Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trial [J]. Lancet， 2001; 358(9292)∶1487.
16. Mochizuki H, Togo S, Tanaka K, et al. Early enteral nutrition after hepatectomy to prevent postoperative infection [J]. Hepatogastroenterology， 2000; 47(35)∶1407.
17. Hu QG, Zheng QC. The influence of enteral nutrition in postoperative patients with poor liver function [J]. World J Gastroenterol， 2003; 9(4)∶843.
18. Hochwald SN, Harrison LE, Heslin MJ, et al. Early postoperative enteral feeding improves whole body protein kinetics in upper gastrointestinal cancer patients [J]. Am J Surg， 1997; 174(3)∶325.
19. Pearlstone DB, Lee JI, Alexander RH, et al. Effect of enteral and parenteral nutrition on amino acid levels in cancer patients [J]. JPEN J Parenter Enteral Nutr， 1995; 19(3)∶204.
20. Sustic A, Krznaric Z, Uravic M, et al. Influence on gallbladder volume of early postoperative gastric supply of nutrients [J]. Clin Nutr， 2000; 19(6)∶413.
21. Pupelis G, Austrums E, Jansone A, et al. Randomised trial of safety and efficacy of postoperative enteral feeding in patients with severe pancreatitis: preliminary report [J]. Eur J Surg， 2000; 166(5)∶383.
22. de Luis DA, Aller R, Izaola O, et al. Postsurgery enteral nutrition in head and neck cancer patients [J]. Eur J Clin Nutr， 2002; 56(11)∶1126.
23. Rayes N, Seehofer D, Hansen S, et al. Early enteral supply of lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients [J]. Transplantation， 2002; 74(1)∶123.
24. Rayes N, Hansen S, Seehofer D, et al. Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery [J]. Nutrition， 2002; 18(7-8)∶609.
25. Braga M, Gianotti L, Nespoli L, et al. Nutritional approach in malnourished surgical patients: a prospective randomized study [J]. Arch Surg， 2002; 137(2)∶174.
26. Wu GH, Zhang YW, Wu ZH. Modulation of postoperative immune and inflammatory response by immuneenhancing enteral diet in gastrointestinal cancer patients [J]. World J Gastroenterol， 2001; 7(3)∶357.
27. Kuru B, Dinc S, Altinok G, et al. Effect of different enteral nutrients on bacterial translocation in experimental obstructive jaundice [J]. Eur Surg Res， 2004; 36(1)∶45.
28. Zulfikaroglu B, Zulfikaroglu E, Ozmen MM, et al. The effect of immunonutrition on bacterial translocation, and intestinal villus atrophy in experimental obstructive jaundice [J]. Clin Nutr， 2003; 22(3)∶277.
29. 伍曉汀. 老年外科手術(shù)患者的營(yíng)養(yǎng)問(wèn)題 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志，2004； 11(2)∶182.
  1. 1. Baskin WN. Advances in enteral nutrition techniques [J]. Am J Gastroenterol， 1992; 87(11)∶1547.
  2. 2. 胡建昆. 外科術(shù)后早期腸內(nèi)營(yíng)養(yǎng) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2003； 10(4)∶407.
  3. 3. Braga M, Gianotti L, Gentilini O, et al. Feeding the gut early after digestive surgery: results of a nineyear experience [J]. Clin Nutr， 2002; 21(1)∶59.
  4. 4. 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 [J]. BMJ， 2001; 323(7316)∶773.
  5. 5. Brooks AD, Hochwald SN, Heslin MJ, et al. Intestinal permeability after early postoperative enteral nutrition in patients with upper gastrointestinal malignancy [J]. JPEN J Parenter Enteral Nutr， 1999; 23(2)∶75.
  6. 6. McCarter MD, Gomez ME, Daly JM. Early postoperative enteral feeding following major upper gastrointestinal surgery [J]. J Gastrointest Surg， 1997; 1(3)∶278.
  7. 7. Detry R, Ciccarelli O, Komlan A, et al. Early feeding after colorectal surgery. Preliminary results [J]. Acta Chir Belg， 1999; 99(6)∶292.
  8. 8. Pacelli F, Bossola M, Papa V, et al. Enteral vs parenteral nutrition after major abdominal surgery: an even match [J]. Arch Surg， 2001; 136(8)∶933.
  9. 9. Braga M, Gianotti L, Gentilini O, et al. Early postoperative enteral nutrition improves gut oxygenation and reduces costs compared with total parenteral nutrition [J]. Crit Care Med， 2001; 29(2)∶242.
  10. 10. Gianotti L, Braga M, Gentilini O, et al. Artificial nutrition after pancreaticoduodenectomy [J]. Pancreas， 2000; 21(4)∶344.
  11. 11. Stewart BT, Woods RJ, Collopy BT, et al. Early feeding after elective open colorectal resections: a prospective randomized trial [J]. Aust N Z J Surg， 1998; 68(2)∶125.
  12. 12. Hsu TC, Leu SC, Su CF, et al. Assessment of intragastric pH value changes after early nasogastric feeding [J]. Nutrition， 2000; 16(9)∶751.
  13. 13. Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: a systematic review [J]. Crit Care Med， 2001; 29(12)∶2264.
  14. 14. Soliani P, Dell’Abate P, Del Rio P, et al. Early enteral nutrition in patients treated with major surgery of the abdomen and the pelvis [J]. Chir Ital， 2001; 53(5)∶619.
  15. 15. Bozzetti F, Braga M, Gianotti L, et al. Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trial [J]. Lancet， 2001; 358(9292)∶1487.
  16. 16. Mochizuki H, Togo S, Tanaka K, et al. Early enteral nutrition after hepatectomy to prevent postoperative infection [J]. Hepatogastroenterology， 2000; 47(35)∶1407.
  17. 17. Hu QG, Zheng QC. The influence of enteral nutrition in postoperative patients with poor liver function [J]. World J Gastroenterol， 2003; 9(4)∶843.
  18. 18. Hochwald SN, Harrison LE, Heslin MJ, et al. Early postoperative enteral feeding improves whole body protein kinetics in upper gastrointestinal cancer patients [J]. Am J Surg， 1997; 174(3)∶325.
  19. 19. Pearlstone DB, Lee JI, Alexander RH, et al. Effect of enteral and parenteral nutrition on amino acid levels in cancer patients [J]. JPEN J Parenter Enteral Nutr， 1995; 19(3)∶204.
  20. 20. Sustic A, Krznaric Z, Uravic M, et al. Influence on gallbladder volume of early postoperative gastric supply of nutrients [J]. Clin Nutr， 2000; 19(6)∶413.
  21. 21. Pupelis G, Austrums E, Jansone A, et al. Randomised trial of safety and efficacy of postoperative enteral feeding in patients with severe pancreatitis: preliminary report [J]. Eur J Surg， 2000; 166(5)∶383.
  22. 22. de Luis DA, Aller R, Izaola O, et al. Postsurgery enteral nutrition in head and neck cancer patients [J]. Eur J Clin Nutr， 2002; 56(11)∶1126.
  23. 23. Rayes N, Seehofer D, Hansen S, et al. Early enteral supply of lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients [J]. Transplantation， 2002; 74(1)∶123.
  24. 24. Rayes N, Hansen S, Seehofer D, et al. Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery [J]. Nutrition， 2002; 18(7-8)∶609.
  25. 25. Braga M, Gianotti L, Nespoli L, et al. Nutritional approach in malnourished surgical patients: a prospective randomized study [J]. Arch Surg， 2002; 137(2)∶174.
  26. 26. Wu GH, Zhang YW, Wu ZH. Modulation of postoperative immune and inflammatory response by immuneenhancing enteral diet in gastrointestinal cancer patients [J]. World J Gastroenterol， 2001; 7(3)∶357.
  27. 27. Kuru B, Dinc S, Altinok G, et al. Effect of different enteral nutrients on bacterial translocation in experimental obstructive jaundice [J]. Eur Surg Res， 2004; 36(1)∶45.
  28. 28. Zulfikaroglu B, Zulfikaroglu E, Ozmen MM, et al. The effect of immunonutrition on bacterial translocation, and intestinal villus atrophy in experimental obstructive jaundice [J]. Clin Nutr， 2003; 22(3)∶277.
  29. 29. 伍曉汀. 老年外科手術(shù)患者的營(yíng)養(yǎng)問(wèn)題 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志，2004； 11(2)∶182.