Objective To investigate the effect and mechanism of growth factors on intestinal compensation after massive intestinal resection， and understand the progress of growth factors in nutrition support treatment for short bowel syndrome （SBS）. Method The related literatures about the application and effect of growth factors in the patients with SBS were reviewed. Results Different kinds of growth factors had different effects on intestinal adaptation after massive intestinal resection. The application of growth factors according to the specific circumstances of the patients with SBS could shorten the residual small intestine compensatory time and improve the nutrition status of the patient with SBS. Conclusions Growth factors play important role in promoting the intestinal adaptation after resection. Different kinds of growth factors have their effects and it’s helpful for getting rid of the total parenteral nutrition early. However， much work still remains to be done.
Objective To investigate the influence of preoperative enteral nutrition with dietary fiber on the nutritional status of patients with colon colostomy diaplasis, and discuss its safety. Methods Forty preoperative colon colostomy diaplasis patients from West China Hospital treated between September 2013 and June 2014 were randomly assigned into trial group and control group with 20 in each. The baseline of the two groups was the same (all P > 0.05). The trial group was given enteral nutrition with dietary fiber before operation for seven days, while control group was given homogenate diet with equal quantity of energy and nitrogen content for the same period of time. All patients were being tested for nutritional indexes on the day of admission and on the fifth day after surgery. Meanwhile, other indexes such as the first time of flatus and defecation, abdominal distension, bellyache, and other adverse reactions were recorded too. Results There was no statistical difference in nutritional indexes on the day of admission and on the fifth day after surgery between two groups (P > 0.05). Patients with dietary fiber had significantly higher incidence of abdominal distension than the control subjects (P < 0.05), but other adverse reactions had no statistical differences between the two groups (P > 0.05). No anastomotic leakage occurred in both the two groups. Patients with dietary fiber had significantly earlier time of flatus than the control group (P < 0.05). Patients with dietary fiber had significantly lower incidence of diarrhea than the control subjects (P < 0.05). Conclusions The study suggests that it is safe and feasible to use enteral nutrition with dietary fiber for preoperative colon colostomy diaplasis patients. Using dietary fiber is helpful for intestinal function recovery and reduction of the occurrence of adverse reactions after surgery.
ObjectiveTo evaluate the safety and efficacy of preoperation administration of enteral nutrition enriched ω-3 fatty acids for gastric cancer patients. MethodsA single center randomized controlled clinical trial was performed in 60 cases of gastric cancer in West China Hospital during January 2014 to June 2014, and cases were equally randomized divided into treatment group and control group. Cases of treatment group were given enteral nutrition enriched ω-3 fatty acids which was manufactured by Fresenius Kabi Deutschland GmbH for 5 consecutive days before operation, and cases of control group were given an isocaloric and isonitrogenous homogenized diet for 5 consecutive days before operation. The laboratory indexes of nutritional status and imflammatory factors were observed and compared between 2 groups on admission, preoperative day 1, postoperative day 3, and postoperative day 5. Liver and kidney function indexes which as the safety indexes were detected on admission and preoperative day 1. Vomiting, diarrhea, and infectious complications were recorded in addition. ResultsOn 3 days after operation, levels of interleukin-6 (IL-6) and α-acid glycoprotein (AAG) of treatment group were both lower than those of control group (P<0.05); on 5 days after operation, levels of C-reactive protein (CRP) of treatment group was lower than that of control group too (P<0.05); but at other time points, there were no significant differences in any index between the 2 groups (P>0.05). During the period of enteral nutrition, only 1 case suffered from bloating and 1 case suffered from diarrhea, both in treatment group, and the incidence of adverse reactions didn't differed between treatment group[6.7% (2/30)]and control group[0 (0/30)], P>0.05. Moreover, there were no significant differences between treatment group and control group in incidences of wound infection[3.3% (1/30) vs. 10.0% (3/30)], abdominal infection[0 (0/30) vs. 3.3% (1/30)], urinary infection[0 (0/30) vs. 3.3% (1/30)], and pulmonary infection[0 (0/30) vs. 6.7% (2/30)], but the total incidence of complication was lower in treatment group than that of control group[3.3% (1/30) vs. 23.3% (7/30)], P=0.026. ConclusionEnteral nutrition enriched ω-3 fatty acids can reduce the rate of infection-related complication for patients with gastric cancer, and has a sense of safety.