(Department of Neursurgery,Guangzhou Second Municipal Peoples Hospital,

Guangzhou 510150，China)

Abstract：Objectives:Patients with severe brain injures require nutritional support becease of an accelerated metabolism and prolonged inability to eat.Because of the high incidence of gastropareis,enteral nutritiona support of patient with acute head injury has traditionally been difficult.This study evaduated that tolerance and effect of modified nasogastric feeding as early nutritional aupport in 41 severe head-injuried patients.Methods:The study group(41 cases) was fed gastrically with the element diet and the control group(39 cases) was nutritional supported with common method.The enteral feeding was started within 48 h post injury for study group versus 6 to 8 days for control group.Results:Evidence indicates that aggressive early enteral feeding regimens using small nasogastric tude were tolerared better than previously believed.As compared with control group,the nitrogen balance,serum albumin,ICr,body weight,were signficantly better in the patients with nasogastric feeding after injury(P＜0.05～P＜0.01).Conclusions:The modified gastric feeding is helpful to the early nutrition and beneficial to improve gut function and the nutritional condition of the severe head-injured patients.

Key words: Head injury;Enteral nutrition;Hypermetabolism

Enteral nutrition supplimented with dietary fiber in

patients with enterocutaneous fistula

JIANG Jun,REN Jian-an,GU Jun et al

(Research Institute of General Surgery,Nanjing General Hosptial of PLA,

Nanjing 210002,China)

Abstract:Objectives:To observe the effect of enteral nutrition on patietns with enterocutaneous fistula,and the effect of dietary fiber on the defective habits.Methods:Thirty-one patient with enterocutaneous fistula were randomly divided into control group,single type DF group and mixed DF group,blood chemistry,nutritional parameters and changes of defective habit were recovered.Results:EN was effective in improving the nutritional conditions of patients with EF and preventing cholestasis after long term TPN.Dietary fiber was effective in controlling diarrhea or constipation,mixed DF was more effective than single type.Conclusions:Enterla nutrition supplimented with DF was effective,safe and well tolerated by patietns with EF.

Key words: Dietary fiber; Enteral nutrition; Enterocutaneous fistula

Nutrition support in severe acute pancreatitis

ZHAO Xu-hui, DAI Yan, HU Shou-hong

(branch of Anhui Provincial hospital,Hefei 230031,China)

Abstract:Objectives:To investigate the value and characteristics of nutritional support in the therapy for patients with severe acute pancreatitis(SAP).Methods:To evaluate the necessity of nutritional support in the treatment of severe acute pancreatitis,total parenleral nutrition(TPN) of low energy with rich aminonitrogen was used in 17 patients.The mixtrue had a glucose/lipid of 1/1 and a energy/aminonitrogen of 418.4 kJ/1 g.TPN was infused through central veins in all patients and was followed by total entral nutrition(TEN) or oral dinner(OD) in individual patients according to the severity of the disease.Results:Nutritional support decreased the acurrence of the complication and lowered the mortality of SAP.Conclusions:Adequated nutritional support had some help in improving the prognosis of severe acute pancretitis.

Key words: Severe acute pancretitis;Nutritional support

The nutritional support for the patient with serious abdominal infection

HU Rui-xiang,LUO Shi-cheng,CHANG Yong-giong

(Department of General Surgery,The First People's Hospital of Yunnan Province,

Kunming 650032,China)

Abstract:Objectives:To evaluate the clinical effects of Hypocaloric parenteral nutrition(HPN) and recombinant human growth hormone(rhGH) on the patient with serious abdominal infection.Methods:HPN and low-dose rhGH(saizen) were given to 40 patients with serious adbominal infection and hypoalbuminosis,their weight,serum albumin,transferrin(TFN),creatinine height index(CHI),total lymphocyte count (TLC) and nitrogen balance were examined.Results:The protein increased significantly(P＜0.05),self-contrast prior to and after the test.Conclusions:The catabolic response of serious abdominal infection can be modified with GH and hypocaloric nutrition,it can improve the protein synthesis and nitrogen balance in short time,increase the clinical effects of nutritional treatment.

Key words: Abdominal infection;Hypoalbuminosis;HPN；rhGH

Nutritional support in serious patients

with mechanical ventilation after cardica operation

WANG Ming-hua, WANG Chun-xiang,LIU Lu-qi et al

(Department of Cardiac Surgery,Qianfoshan Hospital of Shandong Province,

Jinan 250014,China)

Abstract:Objectives:To study the reasonable uses of the nutritional support treatment in the serious patients of post heart operation during mechanical ventilation.Methods:The nutritional support treatment was performed in 87 cases of serious patients post heart operation during mechanical ventilation.TPN was taken from 24 hours after heart operation to the time gastrointestinal function recovered.Then,PN+EN were taken until the patients situations were stable.After completely recovering,EN was taken.Results:The mechanical ventilation time of these patients was 98～557 hours (mean 193±117 hours).There were 25 cases of postoperative death.There were 74.19% survivalcases turned off their mechanical ventilation successfully in first time.The complications of the nutrutionla support were hyperglycemia in 19 cases,hyperlipemia in 5 cases,and hyperbilirubinemia in 15 cases,but no intravenous catheter infection cases.Conclusions:The nutrional support is helpful to correct the metabolic disturbance,supply calorie and raise survival rate.The nutritional support should take the reasonable individual plan.The nutritional support by stages can decrease the complications of TPN,so it is an economical and effective method.

Key words: Post heart operation; Mechanical ventilation; Nutritional support

Bioelectrical impedance assessment of nutritional status

in abdominal tumor patients before and after operation

MIAO Gang, QIAO Jiang-chun,SUN Jian-hua

(Department of General Surgery,Beijing Hospital,Beijing 100730,China)

Abstract:Objectives:To assess the utility of bioelectircal impedance analysis(BIA) in determining nutritional status in abdominal tumor patients preceding and following operat