Application effect of early enteral nutrition support based on enhanced recovery after surgery in perioperative period of children with perforated appendicitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Lei ,  XU Yan , CAO Hui , MENG Xiaowan , ZHANG Yuqi

Department of General Surgery, Xuzhou Children’s Hospital, Xuzhou, Jiangsu 221000, P. R. China;

Corresponding?author：

XU Yan, Email: 779380101@qq.com

Keywords：

enhanced recovery after surgery; early enteral nutrition; perforated appendicitis; perioperative period

DOI：

10.7507/1007-9424.202303023

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effect of early enteral nutrition (EEN) support in the perioperative period of children with perforated appendicitis based on the enhanced recovery after surgery (ERAS). Methods The children with perforated appendicitis were collected as an observation group, who underwent EEN support treatment based on the ERAS mode from January 2021 to December 2022 in the Xuzhou Children’s Hospital. At the same time, the children with perforated appendicitis received conventional nutrition support from January 2019 to December 2020 were matched as a control group according to the principle of balanced and comparable baseline data such as the gender, age, disease course, pathological type, and body mass index with the observation group. The time of first exhaust or defecation and the hospital stay after surgery were compared. Meanwhile, the nutritional indexes [prealbumin (PA), albumin (ALB), hemoglobin (Hb)], immune indexes [immunoglobulin (Ig) A, IgM, IgG], serum inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] before surgery, on day 1 and 7 after surgery were compared. And the adverse effects were observed. Results There were 40 children with perforated appendicitis in the observation group and the control group, respectively. There were no statistical differences in the baseline data such as the gender, age, course of disease, pathological type, and body mass index between the two groups (P>0.05). The time of first exhaust or defecation and the hospital stay after surgery in the observation group were shorter than in the control group (t=3.234, P=0.002; t=5.582, P<0.001). The levels of PA, ALB, Hb, IgA, IgM, and IgG in the observation group were higher than in the control group on day 7 after surgery (P<0.05). The levels of CRP, IL-6, and TNF-α in the observation group were lower than in the control group on day 7 after surgery (P<0.05）. The incidence of adverse reactions in the observation group was lower than that in the control group [5.0% (2/40) vs. 22.5% (9/40), χ²=5.165, P=0.023]. Conclusions From on the results of this study, EEN support based on ERAS during perioperative period of children with perforated appendicitis contributes to recover gastrointestinal function, correct nutritional status, improve immune function, and reduce inflammation, and which has a higher safety for children with perforated appendicitis.

Citation： WANG Lei, XU Yan, CAO Hui, MENG Xiaowan, ZHANG Yuqi. Application effect of early enteral nutrition support based on enhanced recovery after surgery in perioperative period of children with perforated appendicitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(7): 827-832. doi: 10.7507/1007-9424.202303023 Copy

1.	Téoule P, Laffolie J, Rolle U, et al. Acute appendicitis in childhood and adulthood. Dtsch Arztebl Int, 2020, 117(45): 764-774.
2.	黃栩栩, 黃雪霏, 李萍萍, 等. 新生兒和嬰兒急性闌尾炎的臨床特點. 兒科藥學雜志, 2020, 26(8): 20-21.
3.	Rassi R, Muse F, Cuestas E. Acute appendicitis in children under 4 years: a diagnostic dilemma. Rev Fac Cien Med Univ Nac Cordoba, 2019, 76(3): 180-184.
4.	岳亮. 腹腔鏡手術與開腹手術治療小兒穿孔性闌尾炎的臨床療效比較. 中國藥物與臨床, 2021, 21(11): 1910-1911.
5.	Talha A, El-Haddad H, Ghazal AE, et al. Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial. Surg Endosc, 2020, 34(2): 907-914.
6.	Neogi S, Banerjee A, Panda SS, et al. Laparoscopic versus open appendicectomy for complicated appendicitis in children: a systematic review and meta-analysis. J Pediatr Surg, 2022, 57(3): 394-405.
7.	杜冬梅, 劉銘. 不同手術方法治療小兒穿孔性闌尾炎的效果及對炎癥應激反應和免疫功能的影響. 臨床與病理雜志, 2022, 42(3): 641-646.
8.	郭苗. 基于加速康復外科的早期腸內營養支持對結直腸癌手術患者營養及免疫指標的影響. 現代診斷與治療, 2021, 32(4): 637-639.
9.	潘威婕, 常悅, 劉沙, 等. 加速康復外科理念下腸內營養支持在胃癌患者圍手術期的應用. 國際醫藥衛生導報, 2020, 26(7): 1019-1021.
10.	Ma BQ, Chen SY, Jiang ZB, et al. Effect of postoperative early enteral nutrition on clinical outcomes and immune function of cholangiocarcinoma patients with malignant obstructive jaundice. World J Gastroenterol, 2020, 26(46): 7405-7415.
11.	吳芳, 葉再元, 陳振光, 等. 胃癌患者術后早期腸內營養支持的臨床研究. 浙江醫學, 2020, 42(2): 161-163, 191.
12.	Gao X, Liu Y, Zhang L, et al. Effect of early vs late supplemental parenteral nutrition in patients undergoing abdominal surgery: a randomized clinical trial. JAMA Surg, 2022, 157(5): 384-393.
13.	Yirui L, Yin W, Juan L, et al. The clinical effect of early enteral nutrition in liver-transplanted patients: a systematic review and meta-analysis. Clin Res Hepatol Gastroenterol, 2021, 45(3): 101594. doi: 10.1016/j.clinre.2020.101594.
14.	陳錦園, 吳娟, 李娜, 等. 基于循證理念指引下的護理干預在神經外科重癥患者腸內營養支持中的應用. 中國醫藥導報, 2021, 18(22): 185-188.
15.	Lin A, Ye J, Wang Z, et al. Analysis of post-operative efficacy and pharyngeal fistula healing in patients with laryngeal cancer treated with post-operative enteral nutrition support nursing combined with early oral feeding. Oncol Lett, 2020, 19(6): 3964-3970.
16.	Herbert G, Perry R, Andersen HK, et al. Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications. Cochrane Database Syst Rev, 2019, 7(7): CD004080. doi: 10.1002/14651858.CD004080.pub4.
17.	謝周龍龍, 李倩, 張蓉, 等. 加速康復外科理念在兒童日間手術圍術期的應用. 中國衛生質量管理, 2021, 28(12): 4-7.
18.	郭守強. 不同時間點腸內營養支持聯合清胰湯對重度急性胰腺炎患者免疫因子的影響. 西部中醫藥, 2020, 33(4): 115-117.
19.	李欣瑜, 翁文駿, 王靜文, 等. 小百肽營養配方粉在急性淋巴細胞白血病患兒營養支持中的有效性和安全性分析. 中國實用兒科雜志, 2020, 35(2): 120-125, 146.
20.	鄭環宇, 夏巨坤. 內鏡下逆行闌尾炎術治療急性闌尾炎患兒的效果觀察及對免疫功能和炎癥因子水平的影響. 海軍醫學雜志, 2021, 42(4): 461-465.
21.	關麗萍, 尉志強, 關巍, 等. 不同時機腸內營養對重癥急性胰腺炎患者炎性因子與免疫功能的影響. 河北醫藥, 2018, 40(13): 1949-1952.

1. Téoule P, Laffolie J, Rolle U, et al. Acute appendicitis in childhood and adulthood. Dtsch Arztebl Int, 2020, 117(45): 764-774.
2. 黃栩栩, 黃雪霏, 李萍萍, 等. 新生兒和嬰兒急性闌尾炎的臨床特點. 兒科藥學雜志, 2020, 26(8): 20-21.
3. Rassi R, Muse F, Cuestas E. Acute appendicitis in children under 4 years: a diagnostic dilemma. Rev Fac Cien Med Univ Nac Cordoba, 2019, 76(3): 180-184.
4. 岳亮. 腹腔鏡手術與開腹手術治療小兒穿孔性闌尾炎的臨床療效比較. 中國藥物與臨床, 2021, 21(11): 1910-1911.
5. Talha A, El-Haddad H, Ghazal AE, et al. Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial. Surg Endosc, 2020, 34(2): 907-914.
6. Neogi S, Banerjee A, Panda SS, et al. Laparoscopic versus open appendicectomy for complicated appendicitis in children: a systematic review and meta-analysis. J Pediatr Surg, 2022, 57(3): 394-405.
7. 杜冬梅, 劉銘. 不同手術方法治療小兒穿孔性闌尾炎的效果及對炎癥應激反應和免疫功能的影響. 臨床與病理雜志, 2022, 42(3): 641-646.
8. 郭苗. 基于加速康復外科的早期腸內營養支持對結直腸癌手術患者營養及免疫指標的影響. 現代診斷與治療, 2021, 32(4): 637-639.
9. 潘威婕, 常悅, 劉沙, 等. 加速康復外科理念下腸內營養支持在胃癌患者圍手術期的應用. 國際醫藥衛生導報, 2020, 26(7): 1019-1021.
10. Ma BQ, Chen SY, Jiang ZB, et al. Effect of postoperative early enteral nutrition on clinical outcomes and immune function of cholangiocarcinoma patients with malignant obstructive jaundice. World J Gastroenterol, 2020, 26(46): 7405-7415.
11. 吳芳, 葉再元, 陳振光, 等. 胃癌患者術后早期腸內營養支持的臨床研究. 浙江醫學, 2020, 42(2): 161-163, 191.
12. Gao X, Liu Y, Zhang L, et al. Effect of early vs late supplemental parenteral nutrition in patients undergoing abdominal surgery: a randomized clinical trial. JAMA Surg, 2022, 157(5): 384-393.
13. Yirui L, Yin W, Juan L, et al. The clinical effect of early enteral nutrition in liver-transplanted patients: a systematic review and meta-analysis. Clin Res Hepatol Gastroenterol, 2021, 45(3): 101594. doi: 10.1016/j.clinre.2020.101594.
14. 陳錦園, 吳娟, 李娜, 等. 基于循證理念指引下的護理干預在神經外科重癥患者腸內營養支持中的應用. 中國醫藥導報, 2021, 18(22): 185-188.
15. Lin A, Ye J, Wang Z, et al. Analysis of post-operative efficacy and pharyngeal fistula healing in patients with laryngeal cancer treated with post-operative enteral nutrition support nursing combined with early oral feeding. Oncol Lett, 2020, 19(6): 3964-3970.
16. Herbert G, Perry R, Andersen HK, et al. Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications. Cochrane Database Syst Rev, 2019, 7(7): CD004080. doi: 10.1002/14651858.CD004080.pub4.
17. 謝周龍龍, 李倩, 張蓉, 等. 加速康復外科理念在兒童日間手術圍術期的應用. 中國衛生質量管理, 2021, 28(12): 4-7.
18. 郭守強. 不同時間點腸內營養支持聯合清胰湯對重度急性胰腺炎患者免疫因子的影響. 西部中醫藥, 2020, 33(4): 115-117.
19. 李欣瑜, 翁文駿, 王靜文, 等. 小百肽營養配方粉在急性淋巴細胞白血病患兒營養支持中的有效性和安全性分析. 中國實用兒科雜志, 2020, 35(2): 120-125, 146.
20. 鄭環宇, 夏巨坤. 內鏡下逆行闌尾炎術治療急性闌尾炎患兒的效果觀察及對免疫功能和炎癥因子水平的影響. 海軍醫學雜志, 2021, 42(4): 461-465.
21. 關麗萍, 尉志強, 關巍, 等. 不同時機腸內營養對重癥急性胰腺炎患者炎性因子與免疫功能的影響. 河北醫藥, 2018, 40(13): 1949-1952.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application effect of early enteral nutrition support based on enhanced recovery after surgery in perioperative period of children with perforated appendicitis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content