A Comparative Study Of Parenteral And Enteral Nutrition Combined With Double Cannula Irrigation And Parenteral Nutrition Combined With Passive Drainage In The Treatment Of Gastrointestinal Fistula

Objective By studying and comparing the clinical effects of parenteral and enteral nutrition combined with double cannula irrigation and parenteral nutrition combined with passive drainage in the treatment of gastrointestinal fistula to explore the clinical feasibility of parenteral and enteral nutrition combined with double cannula irrigation in the treatment of gastrointestinal fistula.Methods From January 2015 to October 2019,39 patients with gastrointestinal fistula who were treated by gastrointestinal surgery in Ningxia Hui Autonomous Region People's hospital were selected for the study through inclusion and exclusion criteria.According to the treatment plan,they were divided into two groups: Study group and control group,18 cases in the study group were treated with parenteral and enteral nutrition combined with double cannula irrigation and drainage,and 21 cases in the control group were treated with parenteral nutrition combined with passive drainage.General data of two groups of patients were collected(age,sex,location of fistula,original disease,Hypertension,diabetes,coronary heart disease,fatty liver,COPD,anemia),inflammatory indicators(temperature,white blood cell count,percentage of neutrophils,procalcitonin,IL-6 on the 1st,3rd,7th and 14 th day),nutritional indicators(prealbumin,total protein,albumin at 1,7,14 days after fistula and healing),recovery indicators(days of fistula healing,fistula stricture,The difference between hospital stay and BMI after fistula.Through statistical analysis,the clinical therapeutic effects of the two treatments were compared.Results1.General data of patients with gastrointestinal fistulaThere was no significant difference in age,sex,fistula location,original disease,hypertension,diabetes,coronary heart disease,fatty liver and anemia between the two groups(P>0.05),therefore the data of the two groups were comparable.2.Comparison of inflammatory indexes between the two groupsThere was no significant difference in temperature and procalcitonin between the two groups on the 1st,3rd,7th and 14 th day(P>0.05),and there was no significant difference in leukocyte count between the two groups on the 1st and 3rd day(P>0.05),On the 7th and 14 th day,the white blood cell count in the study group was significantly lower than that in the control group(P<0.05).There was no significant difference in the percentage of neutrophils between the two groups on the 1st and 3rd day(P>0.05),but there was significant difference on the 7th and 14 th day(P<0.05).The neutrophil count in the study group was significantly lower than that in the control group.There was no significant difference in the IL-6 between the two groups on the 1st day(P>0.05),but there was significant difference on the 3rd,7th and 14 th day(P<0.05).The IL-6 in the study group was significantly lower than that in the control group.3.Comparison of nutritional indexes between the two groupsThere was no significant difference in nutritional indexes between the two groups on the1 st and 7th day(P>0.05),but there was significant difference on the 14 th day and at the time of fistula healing(P<0.05).The nutritional index in the study group was significantly higher than that in the control group.4.Comparison of recovery indexes between the two groupsThere was significant differences in fistula healing time,fistula stricture cases,hospital stay after fistula and BMI difference between the two groups(P<0.05).The fistula healingtime,fistula stenosis cases,post-fistula hospital stay time and BMI difference in the study group were significantly lower than those in the control group.Conclusion Parenteral and enteral parenteral nutrition combined with double cannula irrigation and drainage in the treatment of gastrointestinal fistula can effectively control inflammation,improve the nutritional status of patients,promote the healing of gastrointestinal fistula,reduce the occurrence of fistula stenosis and shorten the time of hospitalization.It is an effective method for the treatment of gastrointestinal fistula.