The effect of different nutritional modes during perioperative period on infection early after liver transplantation

doi:10.3877/cma.j.issn.1674-3903.2017.04.004

Abstract

Abstract:

Objective

To study the effect of different nutritional modes during perioperative period on infection early after liver transplantation and try to explore a reasonable type of nutritional mode.

Methods

Clinical data of 104 cases getting liver transplantation in the department of organ transplantation, Jiangxi Province People′s Hospital during January 2001 and July 2017, was retrospectively analyzed. All the recipients were divided into total parenteral nutrition (TPN) group (n=51) and non TPN group (n=53) according to the nutritional mode. Recipients in TPN group received TPN via deep vein infusion conduit for 7 days since the first day after surgery, and gradually transiting to euphagia according to recovery condition during 8 to 14 days after operation. Recipients in non TPN group received enteral nutrition (EN) during the first day after surgery, and gradually transiting to part EN plus parenteral nutrition (PN) and totally enteral nutrition(TEN) since the second day after operation. The infection rate and distribution of bacterial and fungal of respiratory tract, enterocoelia, biliary tract, urinary tract, deep vein infusion conduit and digestive tract during 2 weeks after operation were tested. T test was used to compared the age and weight of recipients before operation, Chi-squared test was used to compare the baseline information and the infection rate and distribution of bacterial and fungal during 2 weeks after operation. P<0.05 was considered statistically significant.

Results

There was no statistical significance for the baseline information between the 2 groups (P all >0.05). The infection rate of bacterial and fungal between the 2 groups during 2 weeks after operation were 47% (24/51) and 34% (18/53), 25% (13/51) and 11% (6/53), which had statistical significance (χ²=0.032, 0.041, P all <0.05). The infection rate of bacterial of deep vein infusion conduit between the 2 groups during 2 weeks after operation were 20% (10/51) and 2% (1/53), which had statistical significance (χ² =0.76, P<0.05); the infection rate of fungal of digestive tract between the 2 groups during 2 weeks after operation were 22% (11/51) and 0, which had statistical significance (χ² =0.79, P<0.05).

Conclusion

Application of EN and PN, and gradually transiting to TEN can reduce the infection rate compared with TPN.

Key words: Liver transplantation, Nutritional support, Total parenteral nutrition, Parenteral nutrition, Enteral nutrition, Infection

Liming Ding, Xinchang Li, Wenfeng Luo, Xiaomei Huang, Zhidan Xu. The effect of different nutritional modes during perioperative period on infection early after liver transplantation[J]. Chinese Journal of Transplantation(Electronic Edition), 2017, 11(04): 211-215.

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References 26

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组别	例数	性别(例，男/女)	年龄(岁，±s)	体质量(kg，±s)	原发性肝癌(例)
TPN组	51	31/20	43±10	57±8	30
非TPN组	53	30/23	42±8	59±9	33
t/χ²值	－	0.73	0.82	0.79	0.77
P值	－	>0.05	>0.05	>0.05	>0.05
组别	例数	肝豆状核变性(例)	营养不良(例)		肝硬化类型(例)			Child-Pugh分级(例)
组别	例数	肝豆状核变性(例)	中度	重度	肝炎后肝硬化	胆汁性肝硬化	酒精性肝硬化	A级	B级	C级
TPN组	51	3	33	18	11	5	2	5	28	18
非TPN组	53	4	34	19	12	3	1	4	30	19
t/χ²值	－	0.87	0.76	0.78	0.82	0.79	0.89	0.78	0.81	0.75
P值	－	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	性别(例，男/女)	年龄(岁，±s)	体质量(kg，±s)	原发性肝癌(例)
TPN组	51	31/20	43±10	57±8	30
非TPN组	53	30/23	42±8	59±9	33
t/χ²值	－	0.73	0.82	0.79	0.77
P值	－	>0.05	>0.05	>0.05	>0.05
组别	例数	肝豆状核变性(例)	营养不良(例)		肝硬化类型(例)			Child-Pugh分级(例)
组别	例数	肝豆状核变性(例)	中度	重度	肝炎后肝硬化	胆汁性肝硬化	酒精性肝硬化	A级	B级	C级
TPN组	51	3	33	18	11	5	2	5	28	18
非TPN组	53	4	34	19	12	3	1	4	30	19
t/χ²值	－	0.87	0.76	0.78	0.82	0.79	0.89	0.78	0.81	0.75
P值	－	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	肺部		腹腔		胆道
组别	例数	细菌	真菌	细菌	真菌	细菌	真菌
TPN组	51	5(10)	2(4)	3(6)	2(4)	2(4)	1(2)
非TPN组	53	6(11)	3(6)	2(4)	0	1(2)	1(2)
χ²值	－	0.76	0.85	0.76	0.85	0.78	0.84
P值	－	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05
组别	例数	泌尿道		深静脉导管		消化道
组别	例数	细菌	真菌	细菌	真菌	细菌	真菌
TPN组	51	3(6)	1(2)	10(20)	1(2)	1(2)	11(22)
非TPN组	53	1(2)	1(2)	1(2)	1(2)	2(4)	0
χ²值	－	0.78	0.81	0.76	0.73	0.82	0.79
P值	－	>0.05	>0.05	<0.05	>0.05	>0.05	<0.05

组别	例数	肺部		腹腔		胆道
组别	例数	细菌	真菌	细菌	真菌	细菌	真菌
TPN组	51	5(10)	2(4)	3(6)	2(4)	2(4)	1(2)
非TPN组	53	6(11)	3(6)	2(4)	0	1(2)	1(2)
χ²值	－	0.76	0.85	0.76	0.85	0.78	0.84
P值	－	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05
组别	例数	泌尿道		深静脉导管		消化道
组别	例数	细菌	真菌	细菌	真菌	细菌	真菌
TPN组	51	3(6)	1(2)	10(20)	1(2)	1(2)	11(22)
非TPN组	53	1(2)	1(2)	1(2)	1(2)	2(4)	0
χ²值	－	0.78	0.81	0.76	0.73	0.82	0.79
P值	－	>0.05	>0.05	<0.05	>0.05	>0.05	<0.05

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