Analysis Of The Effect Of Enteral And Parenteral Nutrition In Perioperative Period Of Gastrointestinal Malformation

Objective:Through the analysis the clinical data of the application between the early enteral nutritional support and the general nutritional support after treatment of the patients with the gastrointestinal malformation,we can choose the better clinical nutrition therapy in the clinic nutritional support.Materials and methods:115 patients are chosed in the department of general surgery the Maternal and child health hospital of Zibo city in 2011-2014 years.Those are gastrointestinal malformation patients which need surgery operation,Including 87 cases of male,28 cases of female,aged 1 days-1 months,All patients were treated by surgery operation.Perioperative nutritional support was divided into two groups:A group(conventional treatment group):Only parenteral nutrition is used in the postoperative 5 days,the daily energy expenditure increase to 120%(BEE),5 days later can be given enteral nutrition,and gradually increase the amount of EN,until to the total enteral nutrition by mouth.Group B(early enteral nutrition group):To given the enteral nutrition in the nasogastric tube as soon as possible(when the green juice in the nasogastric tube reduced obviously)after the surgery operation,usually little warm syrup is used,we observe the patients with no obvious symptoms,warm syrup is given continuously by the micropump in 24 hours.And milk or hydrolyzed formula milk is gradually given by the micropump with the speed of 1ml/kg · h,increased speed of 1ml/kg · d,until to the oral enteral nutrition.Others are the same as the A group.Statistical analysis the differences of the two groups children in blood biochemical indicators,nutritional indicators,postoperative complications,length of stay and hospital costs,etc.Results:There was no significant difference of general date in two groups,P>0.05,there was no significant difference of operation time in two groups,,P>0.05.Compared with the exhaust time,hospital costs,hospital time,weight change,differences were statistically significance(P<0.05).Feeding intolerance(vomiting,abdominal distension)was statistically significance.Compared with the control group,there were significant differences in inflammatory response,cholestasis,and necrotic enteritis,P<0.05,which was statistically significant.There was no significant difference between the two groups in the incidence of pneumonia in the two groups,P>0.05.There was no significant difference between the two groups in preoperative laboratory test.The 7 days later’s test showed that the serum albumin,inflammatory index and bilirubin in the EEN group were statistically significant.The average follow-up time was 2 years,the two groups were followed up over 24 months when measuring the index of growth and development of height showed that there were no significant difference(P>0.05),and the children reached the standard growth of China in 2010.Conclusion:Early enteral nutrition was applied by neonates of Gastrointestinal malformation patients in the perioperative period,which had many advantages,such as reliable,low risk,simple implementation,lower the incidence of complications and clinical application of safety.Given the enteral nutrition as soon as possible can improve the nutritional status of patients,reduce the incidence of postoperative complications,which is beneficial to postoperative recovery.In the perioperative period of patients with gastrointestinal malformation,early enteral nutrition can reduce the hospital cost,the hospital time.But follow-up during a long time we can found that the data of gastrointestinal malformations patients were no significant difference between the two groups.