ABSTRACT
Objective To investigate the effect of early early enteral nutrition combined with parenteral nutrition support on postoperative gastrointestinal function,nutritional status and liver function of patients with obstructive jaundice.Methods Sixty-two patients with obstructive jaundice of hepatobiliary who were treated in the General Surgery Department of the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2014 were randomly divided into the control group and the observation group,31 cases in each group.The control group were treated with simple parenteral nutrition,and were injected by central venous catheter at the first day after operation,with the injection tiem of 12-15 h and continuous infusion of 7 d or more.The observation group were received enteral nutrition combined with parenteral nutrition,parenteral nutrition was given first,and the preparation method of the nutrient solution was identical with that of the control group;and then slowly dropped 250 ml physiological saline into the jejunum nutrition tube at the second day,dropped into the enteral nutrition liquid at the third day with the initial dose of 300 to 500 ml per day,slowly dropped in the speed of 20-30 ml/h.Results The first exhaust time,first defecation time and hospitalization time in the observation group were (41.37±6.85) h,(46.85±7.13) h and (12.79±3.76) d,significantly shorter than those in the control group ((57.21 ± 9.23) h,(61.43 ± 10.62) h and (16.94 ± 4.33) d;t =7.67,6.35,4.03;P＜O.05),daily hospitalization expenses was (1637.65± 138.24)yuan,significantly less than that in the control group((2121.42±112.38)yuan;t=15.12;P＜0.05).The serum albumin berofe and after the operation in the control group and observation group were (28.73±3.24) g/L and (29.21±3.31) g/L,(36.85±4.05) g/L and (47.21±4.13) g/L,respectively.The serum pre albumin berofe and after the operation in the control group and observation group were (162.81±31.27) g/L and (163.14±30.56) g/L,(248.95±58.62) g/L and(324.24±61.34) g/L,respectively.There was no difference before operation between the two groups (P＞0.05),while the serum protein levels were significantly increased in observation group than the control group (P＜0.01).There were no difference in ALT,total bilirubin and direct bilirubin levels between the two groups before operation (P ＞ 0.05),after treatment,the levels of ALT,total bilirubin and direct bilirubin in the observation group were significantly higher than those in the control group(P＜0.01).The patients in the two groups recovered well,and no serious adverse reactions occurred.Conclusion Early enteral and parenteral nutrition support in patients with obstructive jaundice has better effect and safety in the clinical treatment.
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Objective Through detecting the expression of triggering receptor expressed on myeloid cells-1 (TREM-1) in pancreas and lung of rats with severe acute panereatitis,to approach the role of TREM-1 in severe actute pancreatitis pathogenesis,and provid a new molecular target for SAP.Methods Thirty healthy male Wistar rat were randomly divided into two groups:control group(group A),n =15 ; severe acute pancreatitis group (group B),n =15.The model of severe acute pancreatitis of rats was induced by retrograde injection of 5％ sodium taurocholate into the pancreatic duct.Results TREM-1 in pancreatic tissues and lung tissues was significantly higher in group B than group A in three time points(6 h,12 h,24 h) and had significant changes(P ＜ 0.05),and had a positive correlation with pancreatic pathology.Conclusion TREM-1 was significantly expressed in severe acute pancreatitis,and aggravated pancreas damage and systemic inflammatory response syndrome.
ABSTRACT
ObjectiveTo explore the safety and therapeutic effect of 8 patients with esophageal Hiatal Hernia treated by laparoscopic hernia repair.MethodsA retrospective analysis was performed on the clinical data of 8 patients with esophageal Hiatal Hernia form Jun.2009 to Jun. 2010.Among the participants,3 conducted 360-degree fundoplication,5 conducted partial(270-degree) fundoplication.Silk sutures were used for the repair of esophageal perforation in 4 patients,and patch repair was used for the other 4 cases.ResultsEight patients were treated by laparoscopic hernia repair,and all of them were cured without postoperative complications.The mean duration of surgery was ( 120 ± 30) min,with average blood loss ( 50 ± 12 ) ml.Patients had a mean postoperative hospital stay of(4.5 ± 2.5 )days.All the patients were followed up for 1 to 2 years,and no case was found to be relapsed.ConclusionTotal laparoscopic hernia repair is minimally invasive,with short recovery course,less pain after surgery,little complication and short hospitalized time.Laparoscopic Hernia repair should be the preferred effective operation method for patients with esophageal Hiatal Hernia.