Clinical significance of setting nasojejunal nutrition tube in Whipple operation / 中国综合临床

ABSTRACT

Objective To investigate the clinical significance of setting nasojejunal nutrition tube in Whipple operation,which can promote patient recovery and prevent complications.Methods Fourty-one patients were undergone Whipple operation and they were randomly divided into eternal nutrition (EN) and parenteral nutrition group (PN).Patients in EN group were set nasojejunal nutrition tube during Whipple operation in order to supply eternal nutrition at earlier period,while in PN group were supplied parenteral nutrition in earlier period.The operative procedure time,the complication in post-operation,the cost of hospitalization and the periods of hospitalization of two groups were recorded.The scores of nutritional status were measured.Results The operative time in EN group and PN group were (200.71 ±51.33)min and (160.48 ± 47.62) min,and no significant difference was found between two groups (t =-1.524,P ＞ 0.05).The hospitalization expenses in EN group was (38835.65 ± 537.69)yuan,lower than that in PN group ((47833.18 ±659.24) yuan,t =2.073,P ＜ 0.05).The hospital periods of EN group and PN group were 10 (3) d and 18(3) d,and the difference was significant (Z =-5.374,P ＜0.001).There were 2 cases who occurred complications after operation in EN group,including 1 cases with incision infection,and 1 cases of pancreatic fistula.Nine cases occurred complications in PN group,including 3 cases with incision infection,2 cases with pancreatic fistula,2 cases with pulmonary infection,2 cases with gastric paralysis,and all were cured by conservative treatment.There was statistically significant difference in the incidence of postoperative complications (P =0.027).All cases with complication were recovery after corresponding treatment.At 7th day after operation,hemoglobin in EN group and PN group were (113.09 ± 12.35) g/L and (107.04 ± 11.81) g/L,and the difference was significant (t =2.035,P ＜ 0.05).The levels of retinol binding protein,serumalbumin,serum prealbumin,serum transferrin in EN group were (42.62 ± 5.64) mg/L,(40.24 ± 6.79) g/L,(321.43±31.28) mg/L,(32.86±4.67) mg/L,(32.86 ±4.67) mg/L,significant different from those in PN group ((15.50 ± 4.26) mg/L,(31.52 ± 5.92) g/L; (197.86 ± 37.71) mg/L,(23.59 ± 4.32) mg/L; t=2.398,2.606,2.119,2.569; P ＜0.01 or P ＜ 0.05).Conclusion Nutritional status and prognosis are improved obviously by setting nasojejunal nutrition tube in Whipple operation.And the cost of hospitalization,the periods of hospitalization are decrease.