Nutritional support in patients with gastrointestinal fistulas and biliary or pancreatic fistulas / 肠外与肠内营养

ABSTRACT

Objectives:To investigate the model and effect of nutritional spport in patients with gastrointestinal fistulas and biliary or pancreatic fistulas. Methods:Step by step nutritional spport was studied in 23 patients with gastrointestinal fistulas and biliary or pancreatic fistulas.The calorie and days provided by different ways of nutritional support and routes of enteral nutrition were reviewed.The nutrition state was evaluated in all cases before TPN and after TEN.Liver functions were observed at the end of every phase of nutrition support. Results:The total hospitalization days of 23 patients were 1 498.TPN,PN+EN and TEN days were 901(60.1%),445(29.7%) and 152(10.2%) respectively,providing non protein calorie of 32.5?5.6,29.5?3.4 and 27.8?4.7 kJ/(kg?d).The routes of enteral nutrition were nasal jejunum tube (13 cases),jejunostomy (5 cases) and nasal gastric tube(2 cases).4 patients died and 19 patients recovered.The nutrition state were significantly improved after nutrition treatment. Conclusions:TPN→PN+EN→TEN→EN+oral feeding was a model of step by step nutritional support,which was effective in patients with gastrointestinal fistulas and biliary or pancreatic fistulas.PN remains the main way providing nutrition support,while EN should be used as soon as possible.