Analysis Of The Therapeutic Effect Of Digestive Juice Reinfusion On Enterocutaneous Fistula

Objective To evaluate the efficacy and safety of digestive juice reinfusion in the treatment of external intestinal fistula by comparing the clinical effects of digestive juice reinfusion and non-reinfusion in the treatment of external intestinal fistula,and to compare the effect of digestive juice reinfusion pump before and after treatment in patients with enterocutaneous fistula,and to provide reference for clinical application of digestive juice reinfusion pump in the treatment of enterocutaneous fistula.Methods 1.A retrospective analysis was made of the clinical data of 90 patients with enterocutaneous fistula admitted to the digestive surgery department of Xijing Digestive Hospital of Air Force Medical University from July 2015 to July 2018.According to whether the digestive juice was reinfusion or non-reinfusion,the patients were divided into digestive juice transfusion group 30 cases and non-transfusion group 60 cases.Nutrition index,inflammation related index,liver function index,time from enterostomy to repayment,time from repayment,complications after repayment,hospitalization time and hospitalization cost were collected to compare the therapeutic effect of digestive juice reinfusion and non-reinfusion on patients with enteric fistula.2.The changes of serum albumin(ALB),total lymphocyte count(TLC),prognostic nutrition index(PNI),body weight,body mass index(BMI)and digestive fluid loss,intravenous fluid replenishment and oral food intake before and after reinfusion in patients with enterocutaneous fistula in the digestive fluid reinfusion pump group were compared.Results 1.There was no significant difference in age,sex,weight,BMI and length of resected intestine between the two groups during enterostomy(P > 0.05);there were significant differences in type of intestinal interruption,smoking,NRS2002 score,proximal and distal intestinal length between the digestive juice reinfusion group and the non-reinfusion group(P < 0.05).There was no significant difference in laboratory nutrition index(PNI,HB,ALB)between the two groups(P > 0.05).There was no significant difference in inflammation and immunity index(LWR,NWR,NLR,NEUT,WBC,TLC)between the two groups(P > 0.05).There was no significant difference in liver function index(ALT,AST)between the two groups(P > 0.05).There was no significant difference between the two groups(P > 0.05).2.There were significant differences in body weight and BMI between the two groups when the stoma was returned(P < 0.05);in laboratory nutritional indicators(PNI,HB,ALB),the indicators in the reinfusion group were superior to those in the non-reinfusion group(P < 0.05);in inflammatory and immune indicators(LWR,NWR,NLR,TLC),the indicators in the reinfusion group were superior to those in the non-reinfusion group,the difference was significant(P < 0.05).There was statistical significance(P < 0.05).There was no significant difference in inflammatory indicators(NEUT,WBC)(P > 0.05);there was no significant difference in liver function indicators(ALT,AST)(P > 0.05);there was no significant difference in the length of hospital stay,hospitalization expenses and operation time(P > 0.05);there was no significant difference in the time from enterostomy to return,the complications prescription after stoma return.The difference was statistically significant(P < 0.05).3.The nutritional indexes of ALB,TLC,PNI,BMI and body weight were significantly different between the two groups before and after digestive juice reinfusion(P < 0.05).There were significant differences in digestive fluid loss,intravenous fluid supplement and oral intake between before and after 10 days(P < 0.05).The average time of achieving the target amount of enteral nutrition was(13.60±6.06)days,and the average amount of enteral nutrition was(1 005.45 ±533.84)m L/d.Conclusions 1.Reinfusion of digestive juice can significantly improve the nutritional status of patients with enterocutaneous fistula,reduce the loss of digestive juice and intravenous fluid supplement,increase oral intake,and promote the recovery of intestinal absorption function.2.Digestive fluid reinfusion can reduce inflammation,improve immune function,reduce the incidence of complications,shorten the waiting time for stoma refund,protect intestinal function and accelerate the recovery of patients.3.The use of digestive juice reinfusion pump can accelerate the early establishment of enteral nutrition channels for patients with enterocutaneous fistula,and it is safe,simple and convenient to use.It can protect the skin around the fistula,not increase the hospitalization costs of patients,but also reduce the burden of nursing staff.