Nutritional Support for Patients with Diseases of Hepatopancreotoduodenal Zone in the Early After the Operational Period

Abstract

AIM: Analysis of the effectiveness of nutritive nutrition in cancer patients in the early post-operative period.

MATERIALS AND METHODS: The examination included 80 patients with an average age of more than 20 years (men – 35, and women – 4 5). All patients for analysis were divided into two groups: The first, the main-receiving strictly enteral and/or probe nutrition (n = 41), the second, control-isolated parenteral nutrition (n = 39). The dynamics of laboratory examination results was assessed – the level of total blood protein, including albumin, the number of lymphocytes, the values of alanine aminotransferase, aspartate aminotransferase, total blood bilirubin, and serum ferritin. In addition, the duration of the use of enteral and parenteral nutrition, the number of patient days in the intensive care unit, the nutritional status of patients on the subjective global assessment (SGA), and nutritional risk index (NRI) scales were evaluated.

RESULTS: Most patients in the control group (n = 31) on the 10–12^th days of the post-operative period, according to the SGA and NRI estimates, were in a state of normal nutritional status (n = 8) – in a state of moderate malnutrition. Since the introduction of parenteral nutrition with enteral nutrition (13–15 days), patients with signs of malnutrition have not been identified in this group. The assessment of the dynamics of total blood protein values in patients showed a significant difference between the average values of indicators in the clinical groups throughout the study period (p < 0.05). In the main group, the average content of total blood protein was 62.5 ± 10.0 g/l, in the control group – 57.5 ± 10.1 g/l by 8 days of the post-operative period. The dynamics of specific indicators of the biochemical composition of blood is determined by the methods of surgical intervention, the volume, duration, and nature of the operation.

CONCLUSIONS: When carrying out nutritional support in cancer patients operated on for tumors, hepatopancreatoduodenal region, in the early post-operative period, the enteral route to the action of nutrient mixtures may be preferable, provided there is a pronounced intestinal paresis and congestive discharge from the stomach.