关键词: 肠内营养, 消化道瘘, 急诊手术

Abstract:

Objective To investigate the effect of enteral nutrition at different time points on the recoveryof patients with gastrointestinal fistula after emergency operation. Methods We retrospectively reviewed the clinicaldata of patients undergoing emergency operation for gastrointestinal fistula in the People′s Hospital of GuangxiZhuang Autonomous Region from January 1，2008 to December 31，2018. 62 patients were divided into 2 groups，the observation group treated with enteral nutrition less than 48h after operation and the control group with enteralnutrition when gastrointestinal function recovered after operation，respectively. Nutrient indexes（albumin，pre⁃al⁃bumin，hemoglobin，transferrin，weight，triceps skinfold and urinary trimethylhistidine） and infection index（WBC，c⁃reactive protein and procaicltonin）were recorded on the 3rd，7th and 14th day after operation in the twogroups. Postoperative complications were retrospectively analyzed in terms of incision infection，bleeding，ventosity，diarrhea and intestinal obstruction. The exsufflation time of anus or stoma，primary healing rate of gastrointestinalfistula，mortality and the hospital length of stay were also compared between these two groups. Results Therewere no significant differences in nutrient index and infection index at the 3rd，7th and 14th day after operationbetween the observation group and control group（P > 0.05）. In terms of postoperative complications，the morbidityof ventosity，diarrhea and intestinal obstruction in the observation group was significantly higher than in the controlgroup（P < 0.05），while it had no significant difference in the rate of incision infection and bleeding between thegroups（P > 0.05）. Otherwise，the longer exsufflation time of anus or stoma and hospital length of stay wereshowed in the observation group（P < 0.05），whereas there was not significant difference in primary healing rate ofgastrointestinal fistula and mortality（P > 0.05）. Conclusion The patients with gastrointestinal fistula have morecomplications such as ventosity，diarrhea and intestinal obstruction when treated enteral nutrition less than 48 hafter emergency operation，and consequently prolong the hospital stay. Thus，enteral nutrition should be appliedduring the recovery of intestinal function.

Key words: enteral nutrition, gastrointestinal fistula, emergency operation