在刚果民主共和国东部布卡武的两家医院进行的一项随机试验:急性全局性腹膜炎术后早期肠内喂养当地制备的蛋白质-能量日粮的益处

IF 2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Gastroenterology Research and Practice Pub Date : 2023-11-17 eCollection Date: 2023-01-01 DOI:10.1155/2023/1764242
Jean Paul Buhendwa Cikwanine, Jonathan Tunangoya Yoyu, Désiré Munyali Alumeti, Bernard Mugisho, John Mutendela Kivukuto, Rivain Fefe Iteke, Ona Longombe Ahuka, Willy Kalau Arung
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引用次数: 0

摘要

背景:急性全身性腹膜炎(AGP)是一种常见而严重的消化外科病理。营养不良使患者病情恶化,影响其术后预后。建议早期肠内营养以减少术后并发症,但其可得性和成本在低收入国家存在问题。本研究的目的是评估在刚果民主共和国东部南基伍省布卡武市的两家医院,使用当地制备的蛋白质能量口粮为肠穿孔AGP术后患者提供早期肠内喂养(EEF)的影响。方法:采用前瞻性、随机对照试验,研究两组患者在回肠穿孔引起的AGP开腹手术后,局部混合EEF与肠内喂养的效果(对照组)。当地的混合物包括大豆、玉米、白米和菠萝。该试验包括66例回肠穿孔性腹膜炎患者。结果:早期肠内喂养与非肠内喂养患者在肠蠕动恢复时间(2.1(0.6)天比3.8(1.2)天,p < 0.0001)和住院时间(25.5(14.9)天比39.4(25.3)天,p = 0.0046)上存在显著差异。双变量分析显示,早期肠内喂养(EEF)显著减少了9.1% (36.4%,p = 0.0082)的壁感染和3.4% (28.1%,p = 0.009)的瘘管(p = 0.009)。此外,EEF显著降低了9.1%的再干预率(p = 0.0003),消除了内脏取出率。EEF还能将营养不良发生率降低63.6% (p < 0.0001)。多因素分析显示,肠内营养显著缩短了肠蠕动恢复时间(p = 0.0278), ORa为0.3,95% CI为0.1 ~ 0.9。此外,EEF减少营养不良(p = 0.0039), ORa为0.1,95% CI为0-0.4。结论:EEF与当地来源的蛋白质能量口粮可以改善患者的营养状况,促进术后恢复。该程序是有利的,涉及使用当地生产的口粮进行早期肠内营养,特别是对刚果民主共和国因急性全身性腹膜炎而进行手术的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Benefits of Early Enteral Feeding with a Locally Prepared Protein-Energy Ration after Surgery for Acute Generalised Peritonitis: A Randomised Trial in Two Hospitals in Bukavu, Eastern Democratic Republic of Congo.

Background: Acute generalised peritonitis (AGP) is a common and serious digestive surgery pathology. Undernutrition exacerbates patient condition and compromises their postoperative prognosis. Early enteral nutrition is recommended to reduce postoperative complications, but its availability and cost are problematic in low-income countries. The objective of this study was to evaluate the impact of providing early enteral feeding (EEF) to postoperative patients with intestinal perforation AGP using a locally prepared protein-energy food ration in two hospitals in Bukavu, a city of South Kivu, in the eastern part of the Democratic Republic of Congo.

Methods: A prospective, randomised controlled trial with two groups of patients was conducted to investigate the effects of EEF with a local mixture versus enteral feeding after peristalsis had returned (control group) in patients who underwent laparotomy for AGP caused by ileal perforation. The local mixture consisted of soybean, maize, white rice, and pineapple. The trial included 66 patients with ileal perforation peritonitis.

Results: The results comparing early enteral fed and nonfed patients showed significant differences in peristalsis recovery time (2.1 (0.6) days vs. 3.8 (1.2) days, p < 0.0001) and length of hospital stay (25.5 (14.9) days vs. 39.4 (25.3) days, p = 0.0046). Bivariate analyses indicated a significant early enteral feeding (EEF) reduced of 9.1% (vs. 36.4%, p = 0.0082) in parietal infections and 3.4% (28.1%, p = 0.009) in fistulas (p = 0.009) when EEF was included. In addition, EEF significantly reduced reintervention rates by 9.1% (p = 0.0003) and eliminated evisceration rates. EEF was also shown to reduce the incidence of malnutrition by 63.6% (p < 0.0001). Multivariate analysis showed that enteral nutrition significantly reduced the time to recovery of peristalsis (p = 0.0278) with an ORa of 0.3 and a 95% CI of 0.1-0.9. Moreover, EEF reduced malnutrition (p = 0.0039) with an ORa of 0.1 and a 95% CI of 0-0.4.

Conclusion: EEF with locally sourced protein-energy rations can enhance a patient's nutritional status and facilitate postoperative recovery. This procedure is advantageous and involved early enteral nutrition using locally manufactured rations, especially for those operated on for acute generalised peritonitis in the Democratic Republic of Congo.

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来源期刊
Gastroenterology Research and Practice
Gastroenterology Research and Practice GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
0.00%
发文量
91
审稿时长
1 months
期刊介绍: Gastroenterology Research and Practice is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on all areas of gastroenterology, hepatology, pancreas and biliary, and related cancers. The journal welcomes submissions on the physiology, pathophysiology, etiology, diagnosis and therapy of gastrointestinal diseases. The aim of the journal is to provide cutting edge research related to the field of gastroenterology, as well as digestive diseases and disorders. Topics of interest include: Management of pancreatic diseases Third space endoscopy Endoscopic resection Therapeutic endoscopy Therapeutic endosonography.
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