Effect of early sequential enteral nutrition support on patients with upper digestive tract perforation after surgery

Objective To investigate the effect of early sequential enteral nutrition support after upper digestive tract perforation. Methods From January 2017 to April 2019,71 patients with upper digestive tract perforation admitted to the surgery department of the Anqing Hospital Affiliated to Anhui Medical University were selected.The patients were randomly divided into observation group (n=36) and control group (n=35) by the table of random number.Jejunal tube was placed before operation followed by sequential enteral nutrition therapy via jejunal tube in the observation group.In the control group,normal gastric tube was retained before operation and total parenteral nutrition support was given postoperatively.BMI,prealbumin,serum albumin,time to passing gas,loss of body weight,length of hospital stay,hospitalization expenses and volume of fluid replacement during fasting were measured preoperatively and at 7 days after operation. Results There was no significant difference in sex,age,body mass index and perforation site between the two groups (P>0.05).At 7 days after operation,the nutritional indexes of the two groups both significantly increased compared to the baseline,and the increases in body mass index,serum albumin and prealbumin in the observation group were significantly higher than those in the control group (all P<0.05).The time to passing gas (3.0±0.8d vs3.6±0.7d),postoperative length of hospital stay,(5.2±2.3d vs7.3±2.6d),total hospitalization cost (12 905±2 723yuan vs15 251±2 742yuan) and volume of fluid replacement during fasting (2 063±241ml vs2 224±264ml) in the observation group were significantly lower than those in the control group (all P<0.05).The incidence of complications in the observation group was lower than that in the control group (22.2% vs 31.4%),but the difference was not significant (P>0.05). Conclusion Early application of sequential enteral nutrition support can improve the nutritional status of patients with upper digestive tract perforation after operation,and accelerate their postoperative recovery.