| ObjectiveThrough the analysis the clinical data of the application of early enteral nutritional support after treatment of the patients with congenital esophageal atresia, to explore the time, scheme and the clinical effect of the application of early enteral nutritional support after treatment of congenital esophageal atresia in children so as to provide guidance in the clinical that better application of early enteral nutrition after the patients with congenital esophageal atresia.Materials and MethodThe clinical data of 73(Ⅲb) patients with esophageal atresia undergoing concurrent esophageal reconstruction in the Third Affiliated Hospital of Zhengzhou University from January 2012 to December 2015 were collected. Randomly selected 38 patients with congenital esophageal atresia as a routine treatment group, which was the Conventional treatment group. The other 35 patients with congenital esophageal atresia were used as early enteral nutrition group. All the patients were treated with parenteral nutrition(PICC) by peripheral venous catheter implantation. The conventional treatment group on the postoperative 5 days via nasogastric tube for enteral nutrition infusion and gradual increase in the amount of enteral nutrition, while decreasing the amount of PN, until the transition to the mouth full enteral feeding. Early enteral nutrition group, 24 h after operation via a nasogastric tube push warm syrup 2.5ml, observe 2h postprandial discomfort symptoms, infusion pump is connected with a nasogastric tube, pump the warm syrup 1ml/kg.h in nasogastric tube for 24 hours last. After 48 hours, by infusion pump continuously pump into the low permeability pressure depth hydrolyzed formula 1ml/kg.h, and the daily increase in the pump intake and added speed 1ml/kg.d, and gradually changed for gravity drip feeding, while decreasing the amount of PN, until the transition to the mouth full enteral feeding. Statistical analysis the differences of two groups children in blood biochemical indicators, nutritional indicators, postoperative complications, length of stay and hospital costs, etc.Results1.Compared with the general clinical data, blood biochemical index and nutrition index of pro-operation of two groups, neonates, the difference was no statistically significant(P>0.05).2.Two groups of children with the blood biochemical indexes of the 8 days postoperative, the levels of total bilirubin, direct bilirubin, early enteral nutrition group respectively(63.81±15.93) umol/L、(39.01±12.74)umol/L, routine treatment group respectively(72.83±15.59) umol/L、(46.83±15.62) umol/L, the early enteral nutrition group below the conventional treatment group, the difference has statistical significance(P﹤0.05). there were statistically significant difference(P﹤0.05) and the conventional therapy group was higher than that of early enteral nutrition group, there was no significant difference in LC、WBC and CRP(P>0.05).3.Two groups of children with the Nutrition related indicators of the 8 days postoperative, the total serum protein, serum prealbumin and hemoglobin, There were statistically significant((P﹤0.05)), and the early enteral nutrition group was higher than that the conventional treatment group. There were no significant difference in γ-glutamyl transpeptidase, glutamic pyruvic transaminase, albumin level, creatinine and urea nitrogen(P>0.05).4.Compared with length of stay and hospital costs two groups, neonates, differences were statistical significance(P﹤0.05). Two groups of children weight change, early enteral nutrition group for weight gain(0.76±0.51)kg, conventional treatment group for weight gain(0.45±0.32)kg, early nutrition group weight in creas--ed more than the conventional treatment group, the difference was statistically significant(P﹤0.05).5.Compared with the incidence of anastomotic leakage and infection of lung of two groups, neonates after surgery, there were not statistically significant difference(P>0.05). There was no significant difference between the two groups in terms of postoperative mortality(P>0.05).Conclusion1.Early enteral nutrition was applied by neonates of congenital esophageal atresia and had many advantages, such as well tolerated, simple implementation, lower the incidence of complications and Clinical application of safety.2.Early enteral nutrition was applied by neonates of congenital esophageal atresia to reduce levels of total bilirubin, direct bilirubin and to prevent the occurrence of cholestasis hepatitis.3.Early enteral nutrition was applied by neonates of congenital esophageal atresia to improve postoperative nutritional status and to help postoperative recovery.4.Early enteral nutrition can reduce length of stay and hospital costs, ease the family financial burden and deserve further clinical applications. |
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