Clinical Application Of Early Postoperative Enteral Nutrition In Congenital High Digestive Tract Malformation

Objective:In recent years,the concept of early enteral nutrition after abdominal surgery has gradually attracted attention.From January 2020 to January 2023,collecting the relevant clinical data of children with congenital high gastrointestinal malformations in the neonatology department of our hospital.In order to give guidance for the practical application of early postoperative enteral nutrition.It is important to investigate the potential,strategy,and clinical impact of early postoperativeenteralnutritioninthetreatmentofhighgastrointestinalmalformation.Methods:From January2020 to January2023,intheneonatologydepartmentof Kunming Children’s Hospital,Yunnan Province,whowerediagnosedwithhighgastrointestinalmalformationsafter surgery.Thepostoperativefeedingmethodswerealloralfeeding,a totalof42 cases,whichwere dividedinto Early Enteral Nutrition(EEN)groupandcontrolgroup.Accordingtothepostoperative enteralnutritiontime.Comparingthetimingofstartingfeedingaftersurgery,thetimingofpartial intravenousnutrition,thetimingoffullenteralnutrition,thedaysofhospitalization,thecosts of hospitalization,weightchanges,theassociatedcomplicationsduringfeeding,inflammatoryindices,nutritionalindicesetc.Thereweresignificantdifferencesbetweenthetwogroups.Results:1.Compared with the preoperative general data(sex,the lesion location,birth weight,age of admission,age of surgery)and nutrition index of the EEN group and the control group,the differencewerenotstatisticallysignificant(P>0.05).2.Compared with the duration of full enteral feeding during recovery,the number of days spent in the hospital,and the expense of hospitalization,there were statistically significantdifference in the twogroups(P<0.05).3.Two groups with the blood biochemical indexes of one week after operation,the total bilirubin,direct bilirubin and glutamic-pyruvic transaminases,there were statistically significant difference(P<0.05).4.Compared with the nutrition-related indicators in the two groups of the day of surgery and one week after surgery,hemoglobin,serum albumin,and total serum protein did not differ significantly from one another(P>0.05),children’s weight increased significantly while they were in the hospital,but there was no statistically significant difference in weight change(P>0.05)between thetwogroups’ differences.5.There were no statistically significant differences in leukocyte and CRP levels between the two groups on the day of surgery and one week following surgery when compared to the inflammatoryindicators(P>0.05).6.Postoperative anastomotic fistula and necrotizing enterocolitis did not significantly differ from the postoperative complications in the two groups(P>0.05).In both groups’ early postoperative diet,therewasfeedingintolerance,butthedifferencewasnotstatisticallysignificant(P>0.05).One kid in the EEN group and 8 children in the control group both had cholestasis associated with parenteralfeeding;thisdifferencewasstatisticallysignificant(P<0.05).Conclusion:1.Early postoperative enteral feeding is the experimental group in this study,while routine nutrition is the control group.The early oral enteral nutrition for children with congenital high digestive tract malformation,which was started 48–72 hours after surgery,was found to be safe and feasibleaftercomparing theclinicalindicatorsofthe two groups ofkids.This canreducetheamount of time spent receiving intravenous nutrition and reduce the amount of time needed to reach total enteralnutrition.2.After the surgery of congenital high gastrointestinal malformations,early enteral nutrition can shorten the length of hospital stay,reduce the cost of hospitalization,and promote the recovery of newborn.3.After the surgery of congenital high gastrointestinal malformations,early enteral nutrition can reducetotal bilirubin,direct bilirubin levels,reduceintravenous nutrition time,reducethe occurrence ofparenteralnutritionassociated cholestasis.