Objective To investigate the effect of short-term administration of growth hormone (GH) on serum insulin-like growth factor-1 (IGF-1) level and nutritional status in patients after gastrointestinal operation, and evaluate whether postoperative application of GH rise the risk of tumor recurrence. Methods Forty-eight patients undergoing major gastrointestinal operation were randomly divided into two groups: GH group （n=24） and control group （n=24）. The two groups received isocaloric isonitrogenous nutrition with daily injection of either GH 0.15 U/kg or placebo for a period of day 3-9 postoperatively. Serum albumin, fibronectin, and IGF-1 were measured before operation as a baseline, and day 3 and 10 after operation using standard laboratory techniques. Nitrogen balance was measured daily from day 3 to day 9 after operation. Postoperative complications and adverse reaction were observed. All cancer patients received regular abdominal B-type ultrasonography and chest X-ray examination during 2 years of follow-up. Results Compared with control group, GH treatment did not influence serum IGF-1 and serum albumin level （Pgt;0.05）, but improved significantly the rise from day 3 to day 10 of serum fibronectin level 〔(22.8±5.8) mg/L vs.（9.6±3.6） mg/L， P＜0.05〕 and the cumulative nitrogen balance 〔（11.37±16.82） g vs.（－9.11±17.52） g， P＜0.01〕 postoperatively. There was no severe adverse effects and complications during GH treatment. The tumor-recurrence rates were not statistically different between two groups during follow-up. Conclusions Short-term administration of low-dose GH combined with early nutrition support can improve total nitrogen retention and protein metabolism, but not influence serum IGF-1 level after major abdominal surgery. Short-term administration of low-dose GH may not cause the tumor-recurrence.
Objective To investigate the effect of early postoperative enteral nutrition support on the balance of free amino acid spectrum in plasma for patients with cardiac valve replacement during perioperative period. Methods (Forty-seven) patients undergoing cardiac valve replacement were divided into two groups randomly, the routine diet group and the Nutrison Fibre group. The levels of free amino acids in plasma were measured with pre-column derivatization of high-performance liquid chromatography. Results During perioperative period most free amino acids in plasma decreased significantly in the routine diet group (Plt;0.05). Despite some free amino acids in plasma decreased significantly in the Nutrison Fibre group(Plt;0.05), all free amino acids in plasma returned to (Pgt;05) or were higher than the preoperative levels in the postoperative sixth day (Plt;0.05). At the same postoperative points, most free amino acids in plasma in the Nutrison Fibre group were higher than that of the routine diet group (Plt;0.05). Conclusions The levels of free amino acids in plasma decrease significantly in patients with cardiac valve replacement after operation. Early postoperative Nutrison Fibre enteral nutrition support is helpful for keeping the balance of free amino acids in plasma for patients with cardiac valve replacement.
Objective To summarize the application of enteral nutrition support in hospitalized patients. Methods The related literatures about enteral nutrition support in recent years were reviewed. Results The rates of malnutrition and nutritional risk were still high in patients. Enteral nutrition support could improve the condition and result of these cases in better clinical outcome, such as shorten hospitalization time and reduced the cost of hospital expenditure. Enteral nutritional support included both oral supplementation and tube-feeding techniques. Artificial nutrition may be provided by nasal tube (nasogastric or nasojejunal tube) or surgically placed tube (gastrostomy, jejunostomy, percutaneous endoscopic gastrostomy or percutaneous endoscopic gastrostomy-jejunostomy). More attention should be paid to the issues relating to feeding intolerance, including abdominal distension, diarrhea, reflux, and aspiration, especially for postoperative patients with early enteral nutrition support. Conclusion Enteral nutrition support requires highly individually and specialized tailored management.
ObjectiveTo compare the outcome between two nutrition support methods, total enteral nutrition (TEN) and enteral nutrition combined with parenteral nutrition, in infants after ventricular septal defect (VSD) repair operation. MethodsWe retrospectively analyzed the clinical data of 76 infants who underwent VSD repair operation in Xinhua Hospital in 2012 year. There were 46 males and 35 females aged 1.6-11.9 (5.5±2.5) months. Nutrition support was started from the first day after operation. There were 35 patients in the group A with TEN 60 kcal/(kg·d), and 41 patients in the group B with both enteral nutrition at 30 kcal/(kg·d) and parenteral nutrition at 30 kcal/(kg·d). ResultsThere was no statistical difference between two groups in demography data and preoperative clinical indicators. The number of patients suffered abdominal distension and gastric retention was more in the group A (22.9% vs. 4.9%, 68.6% vs. 2.4%, P<0.05). There was no difference in diarrhea. The completion of nutrition support in the group A was worse than that in the group B. In the group A, only 40% of the goal calorie was finished on the first and the second day after operation. It was improved until the third day, and the goal calorie could be finished on the seventh day. In the group B, the nutrition support method could be finished on the first day. The prealbumin level in the group B was significantly higher on the third, fifth and seventh day (P<0.05). The blood urea nitrogen (BUN) level in the two groups on the first day after operation was higher than that before operation (P<0.05), and persisted in the group A, while decreased to the normal level gradually in the group B. Following up to discharge, the weight was higher and the length of stay was shorter in the group B (P<0.05). There was no statistical difference in the cost of hospitalization between the two groups (P>0.05). ConclusionThe nutrition support method, enteral nutrition combined with parenteral nutrition, is better than TEN for infants after VSD repair operation.