中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

心脏体外循环手术后危重患者早期肠内营养的应用进展

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体外循环(CPB)手术后早期给予肠内营养治疗在维持肠道完整性、 降低死亡率和增强免疫等方面有很大的益处,既使对CPB手术后的危重患者,也应尽早给予肠内营养治疗,并通过肠外静脉营养来补足能量需求。早期肠内营养治疗对循环不稳定的患者可适度应用,但应注意胃肠并发症及能量供给不足等方面的问题。现就早期肠内营养对消化系统的保护机制和作用、CPB手术后危重患者肠内营养的方法、实施早期肠内营养中应注意的问题和展望等进行综述。

Early enteral nutrition after cardiopulmonary bypass (CPB) has been shown to have beneficial effects on intestinal integrity, lower mortality and also on the patient’s immunocompetence. Even in critical patients after CPB, enteral nutrition should be reasonable to start early and also be supplemented by parenteral nutrition in order to meet energy requirement. We conclude that enteral nutrition is preferable in the majority of patients with severe hemodynamic failure, but gastrointestinal complication and hypocaloric feeding should be simultaneously noticed. This paper comprehensively described enteral nutrition’s protective mechanism and effects on digestive system, enteral nutrition’s implementing methods after CPB, and problems or prospects needing attention in execution.

关键词: 体外循环; 早期肠内营养; 循环衰竭

Key words: Cardiopulmonary bypass; Early enteral nutrition; Hemodynamic failure

引用本文: 李秋泽,徐志云. 心脏体外循环手术后危重患者早期肠内营养的应用进展. 中国胸心血管外科临床杂志, 2008, 15(5): 383-385. doi: 复制

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