目的：探讨早期肠内营养管理模式在胰十二指肠切除术（PD）后护理中的疗效。方法：选择2021年1月至6月南京大学医学院附属鼓楼医院肝胆外科收治的67例PD患者为对照组，2021年7月至12月收治的46例PD患者为实验组。对照组采用全肠外营养为主的营养管理模式，实验组采用肠内营养为主的营养管理模式。比较两组患者在手术前后营养状态、治疗费用、住院时间及并发症情况。结果：实验组术后第7天的血清白蛋白（Alb）、前白蛋白（PA）水平均显著高于对照组，且术前与术后的差值均低于对照组（P<0.05）。实验组总住院时间、术后住院时间、住院费用均低于对照组（P<0.05）。实验组胰瘘、胆瘘发生率显著低于对照组（P<0.05）。结论：以早期肠内营养为主的营养管理模式能显著降低PD术后患者的并发症发生率，加速患者术后康复，降低医疗费用，缩短住院时间。

[1] 赵寿文, 何向辉, 田伟军, 等.胰十二指肠切除术后不同营养支持方式的疗效比较[J].肠外与肠内营养, 2016, 23(1):37-40.
[2] 俞梦英, 卢芳燕, 应华杰.胰十二指肠切除术后患者早期肠内营养的最佳证据总结[J].中华护理杂志, 2021, 56(1):62-68.
[3] BASSI C, MARCHEGIANI G, DERVENIS C, et al.The 2016 update of the international study group(ISGPS) definition and grading of postoperative pancreatic fistula:11 years after[J].Surgery, 2017, 161(3):584-591.
[4] KOCH M, GARDEN O J, PADBURY R, et al.Bile leakage after hepatobiliary and pancreatic surgery:a definition and grading of severity by the international study group of liver surgery[J].Surgery, 2011, 149(5):680-688.
[5] WENTE M N, BASSI C, DERVENIS C, et al.Delayed gastric emptying(DGE) after pancreatic surgery:a suggested definition by the international study group of pancreatic surgery(ISGPS)[J].Surgery, 2007, 142(5):761-768.
[6] BESSELINK M G, VAN RIJSSEN L B, BASSI C, et al.Definition and classification of chyle leak after pancreatic operation:a consensus statement by the international study group on pancreatic surgery[J].Surgery, 2017, 161(2):365-372.
[7] HARNOSS J C, ULRICH A B, HARNOSS J M, et al.Use and results of consensus definitions in pancreatic surgery:a systematic review[J].Surgery, 2014, 155(1):47-57.
[8] 刘水, 盛基尧, 张学文.胰十二指肠切除术的应用现状及进展[J].国际外科学杂志, 2022, 49(6):365-371.
[9] WU J M, KUO T C, CHEN H A, et al.Randomized trial of oral versus enteral feeding for patients with postoperative pancreatic fistula after pancreatoduodenectomy[J].Br J Surg, 2019, 106(3):190-198.
[10] 尹捷, 贾宏岩, 赵建国.胰十二指肠切除术后早期肠内营养支持的护理作用评估[J].内蒙古医科大学学报, 2018, 40(S1):331-333.
[11] RAYES N, SEEHOFER D, THERUVATH T, et al.Effect of enteral nutrition and synbiotics on bacterial infection rates after pylorus-preserving pancreatoduodenectomy:a randomized, double-blind trial[J].Ann Surg, 2007, 246(1):36-41.
[12] WEIMANN A, BRAGA M, HARSANYI L, et al.ESPEN guidelines on enteral nutrition:surgery including organ transplantation[J].Clin Nutr, 2006, 25(2):224-244.
[13] GIANOTTI L, BESSELINK M G, SANDINI M, et al.Nutritional support and therapy in pancreatic surgery:a position paper of the international study group on pancreatic surgery(ISGPS)[J].Surgery, 2018, 164(5):1035-1048.
[14] 高慧, 陆际平, 付佳.早期肠内营养应用于胰十二指肠切除术后护理中的效果分析[J].中国实用医药, 2019, 14(33):169-170.
[15] 杨均兴, 叶思严, 戴东.胰十二指肠切除术后胰瘘的相关危险因素及预防措施的最新进展[J].世界华人消化杂志, 2020, 28(18):914-919.
[16] 朱帅帅.血清前白蛋白对胰十二指肠切除术术后胰瘘的预测价值[D].大连:大连医科大学, 2021.
[17] VAN DER GAAG N A, VERHAAR A C, HAVERKORT E B, et al.Chylous ascites after pancreaticoduodenectomy:introduction of a grading system[J].J Am Coll Surg, 2008, 207(5):751-757.
[18] 王志敏.胰腺术后乳糜瘘危险因素的荟萃分析[D].大连:大连医科大学, 2019.