腹部外科術(shù)后乳糜漏三種非手術(shù)治療方式的療效分析
發(fā)布時間：2019-05-07 13:47
【摘要】：目的通過對比低脂飲食(Low fat diet,LFD)、全胃腸外營養(yǎng)(Total parenteral nutrition,TPN)、全胃腸外營養(yǎng)+生長抑素(Total parenteral nutrition and somatostatin,TPN+S)三種非手術(shù)治療方式治療腹部外科術(shù)后乳糜漏(Chylous leakage,CL)的療效,尋找最佳的治療策略,以期改善患者愈后。方法通過對我院2011年6月至2016年6月35例腹部外科術(shù)后乳糜漏患者進(jìn)行回顧性分析,收集其一般臨床資料及相應(yīng)的療效指標(biāo),其中5例患者因不合乎納入標(biāo)準(zhǔn)而除外。根據(jù)治療方式的不同分成三組,共30例患者納入分組,其中LFD組7例,TPN組10例,TPN+S組13例。比較三組患者的治療后乳糜漏消失時間、再次正常飲食時間、拔出引流管時間及住院時間等療效指標(biāo),p0.05為差異有統(tǒng)計學(xué)意義。結(jié)果治療后乳糜漏消失時間、再次正常飲食時間、拔出引流管時間和住院時間,LFD組分別為(24.29±5.59)d,(26.43±4.93)d,(29.00±4.62)d,(32.57±4.86)d,TPN組分別為(17.10±1.20)d,(20.20±1.03)d,(23.30±1.64)d,(26.60±2.17)d,TPN+S組分別為(15.69±1.03)d,(18.77±1.01)d,(21.54±1.45)d,(24.38±1.56)d,兩兩比較差異均有統(tǒng)計學(xué)意義(P0.05)。且TPN+S組優(yōu)于TPN組,TPN組優(yōu)于LFD組(P0.05)。結(jié)論腹部外科術(shù)后乳糜漏是一種少見的并發(fā)癥,絕大部分患者可經(jīng)非手術(shù)療法治愈,其首選治療方案為給予全胃腸外營養(yǎng)+生長抑素。
[Abstract]:Objective to compare (Low fat diet,LFD (low fat diet), (Total parenteral nutrition,TPN (total parenteral nutrition) and (Total parenteral nutrition and somatostatin,TPN S (total parenteral nutrition) in the treatment of chylous leakage (Chylous leakage, after abdominal surgery. CL) to find the best treatment strategy in order to improve the recovery of patients. Methods from June 2011 to June 2016, 35 patients with chylous leakage after abdominal surgery in our hospital were retrospectively analyzed. The general clinical data and corresponding therapeutic indexes were collected. Among them, 5 patients were excluded because they did not meet the inclusion criteria. According to the different treatment methods, 30 patients were divided into three groups: LFD group (7 cases), TPN group (10 cases) and, TPN S group (13 cases). After treatment, the time of disappearance of chylous leakage, the time of re-normal diet, the time of pulling out the drainage tube and the length of hospitalization were compared among the three groups. There was significant difference between the three groups (p0.05). Results after treatment, the time of disappearance of chylous leakage, the time of normal diet, the time of pulling out the drainage tube and the length of hospitalization in LFD group were (24.29 鹵5.59) d, (26.43 鹵4.93) d, (29.00 鹵4.62) d, (32.57 鹵4.86) days, respectively. (17.10 鹵1.20) d, (20.20 鹵1.03) d, (23.30 鹵1.64) d, (26.60 鹵2.17) days in TPN group and (15.69 鹵1.03) d, (18.77 鹵1.01) d, (21.54 鹵1.45) days in group S, respectively. (24.38 鹵1.56) d, there was significant difference between the two groups (P0.05). TPN S group was better than TPN group, TPN group was better than LFD group (P0.05). Conclusion Chylous leakage after abdominal surgery is a rare complication. Most of the patients can be cured by non-operative therapy. The first choice for the treatment is to give total parenteral nutrition somatostatin.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R656
[Abstract]:Objective to compare (Low fat diet,LFD (low fat diet), (Total parenteral nutrition,TPN (total parenteral nutrition) and (Total parenteral nutrition and somatostatin,TPN S (total parenteral nutrition) in the treatment of chylous leakage (Chylous leakage, after abdominal surgery. CL) to find the best treatment strategy in order to improve the recovery of patients. Methods from June 2011 to June 2016, 35 patients with chylous leakage after abdominal surgery in our hospital were retrospectively analyzed. The general clinical data and corresponding therapeutic indexes were collected. Among them, 5 patients were excluded because they did not meet the inclusion criteria. According to the different treatment methods, 30 patients were divided into three groups: LFD group (7 cases), TPN group (10 cases) and, TPN S group (13 cases). After treatment, the time of disappearance of chylous leakage, the time of re-normal diet, the time of pulling out the drainage tube and the length of hospitalization were compared among the three groups. There was significant difference between the three groups (p0.05). Results after treatment, the time of disappearance of chylous leakage, the time of normal diet, the time of pulling out the drainage tube and the length of hospitalization in LFD group were (24.29 鹵5.59) d, (26.43 鹵4.93) d, (29.00 鹵4.62) d, (32.57 鹵4.86) days, respectively. (17.10 鹵1.20) d, (20.20 鹵1.03) d, (23.30 鹵1.64) d, (26.60 鹵2.17) days in TPN group and (15.69 鹵1.03) d, (18.77 鹵1.01) d, (21.54 鹵1.45) days in group S, respectively. (24.38 鹵1.56) d, there was significant difference between the two groups (P0.05). TPN S group was better than TPN group, TPN group was better than LFD group (P0.05). Conclusion Chylous leakage after abdominal surgery is a rare complication. Most of the patients can be cured by non-operative therapy. The first choice for the treatment is to give total parenteral nutrition somatostatin.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R656
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