| In 460 BC, the great father of medicine Hippocrates recorded the first surgical hemorrhoid treatment: "line of suture with thick wool and fixed." Since then, a variety of traditional surgical treatment of hemorrhoids include: 1, sclerotherapy, cryosurgery. 2, rubber band ligation (hemorrhoids ligation ). 3, surgical excision. With the ever-changing modern medicine, in the late 70's to the hemorrhoid understanding of people turned a historic one, proposed the "anal cushions" doctrine. The theory is that: the essence of hemorrhoid tissue is the body's normal tissues, only when its mast and shift over time lead to pathology, physiological changes. The formation of hemorrhoids. Ideal principle of hemorrhoid treatment does not change the anus in normal tissue structure and function based on the shift from the hemorrhoid tissue hypertrophy to normal. Through nearly 30 years of clinical application, this theory has been most recognized anorectal surgeon, followed surgical procedures based on this theory ----- PPH was born. Through years of clinical practice, PPH Hemorrhoid surgery on its many advantages set off a revolution.PPH is present the most popular surgical procedures on the anal disease for internal hemorrhoids, rectal mucosa prolapse, rectocele treatment around the world. PPH research has great progress in surgical operation, complications of care, but the the research of nutritional status and diet of patients with PPH is still lacking. Currently the diet program after PPH do not have a uniform standard. After many years of clinical observation of our department found that enteral nutrition in the maintenance of nutritional status and improvement of immunity is beter than total parenteral nutrition and flow. Component Based Enteral Nutrition due to poor palatability ,not suitable for PPH patients with oral ;On the other hand Uncomponent Based Enteral Nutrition can produce a small amount of feces that may affect the bowel, but no clinical evidence.In order to study if there are differences between enteral nutrition support and intravenous fluid replacement diet alone of patients with PPH on nutritional status and bowel movement , the paper selected in February 2009 -2 010 years, in April the First Clinical Hospital of Jilin University for 30 patients with hemorrhoids, rectocele, rectal mucosal prolapse . Has already ruled out metabolic disease, preoperative gastrointestinal obstruction, severe malnutrition need to preoperative parenteral nutrition, preoperative radiotherapy and chemotherapy situation.They were randomly divided into two groups ,in accordance with Intravenous rehydration + drinking water and oral enteral nutrition + water. Enteral nutrition choices Nutrison (Nutrison Nutricia Pharmaceutical Co., Ltd.), which as an integral protein, a kind of Uncomponent Based Enteral Nutrition, better palatability, low residue. Preoperative routine check mention prealbumin, albumin, hemoglobin and other nutritional indicators. Those indicators would be compared with postoperative ones to see if there are changes. At the same time, patients were observed 3 days postoperatively of bowel movements to see if there are differences. The results showed: the nutritional status with EN were significantly better than the nutritional status of patients with vien fluid infusion. The indicators as PA, LYC had no differences around operation with EN(p>0.05), but they had significant difference with TPN(p<0.01); The indicators as ALB, HGB had no difference around the operation in both teams, and the bowel movements had no difference also. Comprehensive analysis concluded that: Nutrison to some extent to meet the nutritional needs of patients, it has no significant effect on defecation. Oral Nutrison for PPH patients after operation as an alternative diet is a safe, economical, simple and effective method, It is worthy of promotion. |
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