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The application of nutrition support in conservative treatment of chylous ascites after abdominal surgery

机译:营养支持在腹部手术后乳糜性腹水保守治疗中的应用

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Background: Chylous ascites is the pathologic leakage of triglycerides-rich lymphatic fluid into the peritoneal cavity. Chylous ascites is a rare complication in abdominal surgery. This study aimed to find a relatively better method for nutrition support in the treatment of chylous ascites after abdominal surgery. Methods: This study was a retrospective study. This study retrospectively reviewed patients who underwent abdominal surgery and developed chylous ascites, from the year 2010 to 2014, at the West China Hospital of Sichuan University and the Affiliated Hospital of Zunyi Medical College. Fifty-eight patients who developed chylous ascites after abdominal surgery were included in the study. The clinical effect of somatostatin was evaluated. The differences in the curative efficacy among a daily diet, a low-fat diet supplemented with medium-chain triglyceride (MCT), and total parenteral nutrition (TPN) were also analyzed in this study. Results: Complete clinical success was reached earlier in patients treated with somatostatin ( P <0.001). The tube removal time, the time to resumption of an oral diet, and the length of hospital stay after chylous leakage were significantly different between patients treated with and without somatostatin. The curative efficacies of the enteral nutrition (EN) + MCT plan and the TPN plan were quite similar, with no significant difference, however, were significantly different from the MCT regime, which was the worst. However, using the EN?+ MCT plan was more cost-effective ( P =0.038). Conclusion: In treating chylous ascites, EN + MCT instead of TPN was the best nutrition support. Moreover, somatostatin or its analog octreotide should be used immediately. The treatment with somatostatin in combination with EN + MCT is recommended in the conservative treatment of postoperative chylous ascites.
机译:背景:乳状腹水是富含甘油三酸酯的淋巴液进入腹膜腔的病理性渗漏。乳糜性腹水是腹部手术中罕见的并发症。这项研究旨在寻找一种相对更好的营养支持方法,用于腹部手术后乳糜性腹水的治疗。方法:本研究为回顾性研究。本研究回顾性分析了2010年至2014年在四川大学华西医院和遵义医学院附属医院接受腹腔手术并出现乳突性腹水的患者。本研究纳入了58例在腹部手术后出现乳突性腹水的患者。评价生长抑素的临床效果。在这项研究中,还分析了日常饮食,低脂饮食和中链甘油三酸酯(MCT)以及总肠胃外营养(TPN)之间的疗效差异。结果:生长抑素治疗的患者较早达到了完全的临床成功(P <0.001)。在使用和未使用生长抑素的患者中,拔管时间,恢复口服饮食的时间以及乳糜漏后的住院时间明显不同。肠内营养(EN)+ MCT计划和TPN计划的疗效非常相似,但无显着差异,但与MCT方案有显着差异,后者是最差的。但是,使用EN?+ MCT计划更具成本效益(P = 0.038)。结论:在治疗乳糜性腹水中,EN + MCT代替TPN是最佳的营养支持。此外,应立即使用生长抑素或其类似物奥曲肽。建议在术后乳糜性腹水的保守治疗中使用生长抑素联合EN + MCT进行治疗。

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