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Determination of Recovery Time of Intestinal Absorption Function after Gastrointestinal Surgery and the Effect of the Implementation of Enteral Nutrition at This Time

Author: HuZuo
Tutor: JiangCongQiao
Course: Surgery
Keywords: After gastrointestinal operation Enteral Nutrition Methylene blue Early stage Small intestine Absorption function
CLC: R656
Type: Master's thesis
Year: 2012
Downloads: 51
Quote: 0
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Background: Enteral nutrition (EN), compared with parenteral nutrition (PN) hasmany advantages, in line with the implementation of the EN conditions of choice inpatients with EN after gastrointestinal surgery has become the consensus of surgeons,but on postoperative EN specific implementation time to achieve the best clinicalresults, it is still the focus of debate. EN started too early, the patients were still in theintestinal paralysis, because the absorption feature is not yet restored. EN started toolate, its effect will be greatly reduced. Therefore, the determination of gastrointestinalsurgery in patients with small intestine absorb the time of functional recovery, andthen at this time in patients with EN support, and to observe its effect, and thencompared with the effect of EN support for patients in the traditional time, concluded.It has guiding significance for the early postoperative EN application.Objective: The purpose of this study is to determine the gastrointestinal tract surgeryin patients with intestinal absorption capacity back to the time of the preoperativelevel, and through the implementation of EN clinical effects observed at this time,come to the best starting time of the clinical implementation of the EN.Methods:(1)The first part (Determination of intestinal absorption experiment):randomly selected80cases of gastrointestinal tumors diagnosed in our hospital fromMay2010to October2011and underwent surgery in hospitalized patients, including72cases of gastric cancer,8cases of pancreaticoduodenal tumors,45males and35females, aged from25to85years old, divided into four groups (n=20), that is, after0h group、after6h group、after12h group and the preoperative group(control group),each group of18cases of gastric cancer patients,2cases of pancreaticoduodenalcancer patients, respectively after0h,6h,12h by lien intraoperative nasojejunal feeding tube methylene blue reagent60mg/6ml by20ml syringe slowly push injectedinto the upper jejunum, in the control group of patients before surgery through thetube and slowly push the same dose of methylene blue reagent, collected four groupsof patients the urine within6h thereafter, urine methylene blue absorbance byspectrophotometer,then calculated by the absorbance formula of methylene blueconcentration in the urine, thus proving its quality, and thus indirectly determinedintestinal absorption function,and obtained the recovery time of postoperativeintestinal absorption.(2)The second part (the EN experimental effect): In addition randomly selected40cases of gastrointestinal tumors diagnosed in our hospital from May2010to October2011and underwent surgery in hospitalized patients, in which gastric cancer36cases,4cases of pancreaticoduodenal tumors, and20males,20females, aged from25to85years, divided into2groups (n=20), after6h group and48h after surgery (controlgroup), each group of patients with gastric cancer18cases,2cases ofpancreaticoduodenal tumors, postoperative6h,48h after be EN formulations,compare two groups of postoperative2d postoperative recovery of bowel movementand the incidence of anal exhaust time and abdominal discomfort, and postoperative7d routine blood, liver, kidney function and blood sugar targets, so as to explore theefficacy when intestinal absorption function is restored to give support to patientswith EN.Results:(1) The first part (Determination of intestinal absorption experiment) groupat6h and12h after surgery group and control group, respectively, compared to theintestinal absorption of methylene blue the quality was no significant difference (p>0.05); after0h group, respectively with the control group at6h group, andpostoperative12h group compared to the small intestine to absorb the quality ofmethylene blue were significantly different (p <0.05).(2) The second part (the ENexperimental effect), compared with the control group, experimental group,postoperative bowel recovery time (p <0.05) in advance, ahead of first flatus (p<0.05), the incidence of abdominal distension and abdominal pain increased (p <0.05); the experimental group and control group after7d routine blood, liver and renalfunction and blood sugar were no significant differences (p>0.05).Conclusions: Gastrointestinal tract6hours after surgery in patients with intestinalabsorption has been returned to preoperative levels, but also in patients with ENsupport will help to promote the recovery of bowel function after surgery is safe andfeasible clinical effect, it is worth promoting.

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CLC: > Medicine, health > Surgery > Of surgery > Abdominal surgery
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