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目的评估老年糖尿病患者胃肠肿瘤术后早期肠内营养对血糖的影响。方法76例老年糖尿病患者行胃肠手术后随机分为肠内营养、肠外营养组。术后第2天起分别给予肠内营养或肠外营养支持,并根据血糖情况配合胰岛素治疗。每天监测血糖,于术后第4、8天测各项营养、生化指标,观察临床恢复情况。结果肠内营养组血糖水平显著低于肠外营养组(P<0.01)。术后第4天观察,营养指标(HGB、Alb、TP)EN组较PN组改善(P<0.01),生化指标(TF、ALT、TBIL)EN组较PN组术后第4天升高(P<0.01)。患者均可耐受术后肠内或肠外营养支持,无一例发生严重并发症。结论胃肠肿瘤手术后早期应用肠内营养对老年糖尿病患者是一个较好的方法,不会引起血糖较大波动,方便血糖调控,同时可促进体能恢复,减少并发症。
Objective To evaluate the effects of early postoperative enteral nutrition on blood glucose in elderly patients with diabetic nephropathy. Methods 76 elderly diabetic patients were randomly divided into enteral nutrition group and parenteral nutrition group after gastrointestinal surgery. On the 2nd postoperative day, enteral nutrition or parenteral nutrition support was given respectively, and insulin treatment was performed according to the blood glucose level. Blood glucose was monitored daily, and various nutritional and biochemical indexes were measured on the 4th and 8th days after operation to observe the clinical recovery. Results The level of blood glucose in enteral nutrition group was significantly lower than that in parenteral nutrition group (P <0.01). After 4 days of operation, the indexes of nutrition (HGB, Alb, TP) in EN group were better than those in PN group (P <0.01) P <0.01). Patients can tolerate postoperative enteral or parenteral nutrition support, no case of serious complications. Conclusion Early enteral nutrition after gastrointestinal cancer surgery is a good method for elderly patients with diabetes, which will not lead to large fluctuations in blood sugar, facilitate blood sugar regulation, and promote physical recovery and reduce complications.