目的比较全肠内营养与肠内营养联合肠外营养治疗方案对婴儿室间隔缺损(VSD)修补术后转归的影响。方法回顾性分析上海交通大学医学院附属新华医院2012年1~12月于婴儿期行VSD修补术76例患儿的临床资料,其中男46例、女30例,月龄1.6~11.9(5.5±2.5)个月。根据术后营养治疗方案分为全肠内营养组(A组)35例,肠内营养联合肠外营养组(B组)41例。患儿均自术后第1 d起给予营养治疗。A组给予60 kcal/(kg·d)全肠内营养治疗,B组给予30 kcal/(kg·d)肠内营养联合30 kcal/(kg·d)肠外营养治疗。记录患儿术前、术后营养相关临床及生化指标。结果两组患儿人口统计学、术前各项临床及生化指标差异无统计学意义。A组术后腹胀(22.9%vs.4.9%)、胃潴留(68.6%vs.2.4%)发生率显著高于B组(P<0.05),两组腹泻发生情况差异无统计学意义(P>0.05)。A组营养治疗方案完成情况显著低于B组,A组术后第1 d、第2 d仅完成目标热卡的40%左右,直到术后第3 d才逐渐改善,术后第7 d基本能完成营养治疗方案;而B组自术后第1 d起就可以基本完成营养治疗方案。B组前白蛋白值在术后第3 d、5 d、7 d显著高于A组(P<0.05)。两组术后第1 d尿素氮值较术前明显升高(P<0.05),之后A组始终维持于较高水平,而B组自术后第3 d起缓慢下降至正常。随访至出院,B组患儿体重明显高于A组[(8.2±1.2)kg vs.(6.8±1.6)kg,P<0.05],术后总住院时间短于A组[(18.5±10.1)d vs.(21.0±11.4)d,P<0.05],两组住院总费用差异无统计学意义(P>0.05)。结论婴儿期行VSD修补术后患儿给予肠内营养联合肠外营养治疗,其效果优于全肠内营养治疗。 Objective To compare the effects of total enteral nutrition and enteral nutrition in the treatment of infantile ventricular septal defect (VSD). Methods The clinical data of 76 children undergoing VSD repair in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January to December 2012 were retrospectively analyzed. There were 46 males and 30 females with a mean age of 1.6 to 11.9 months 2.5) months. According to the postoperative nutrition treatment plan, 35 cases were enteral nutrition group (group A), 41 cases were enteral nutrition group (group B). Children were given nutrition treatment from the first day after operation. Group A received total enteral nutrition at 60 kcal / (kg · d), Group B received enteral nutrition at 30 kcal / (kg · d) combined with 30 kcal / (kg · d) parenteral nutrition. Record children with preoperative and postoperative nutrition related to clinical and biochemical indicators. Results The demographics of the two groups of children, preoperative clinical and biochemical differences were not statistically significant. The incidence of postoperative abdominal distension (22.9% vs.4.9%) and gastric retention (68.6% vs.2.4%) in group A was significantly higher than that in group B (P <0.05). There was no significant difference in the incidence of diarrhea between the two groups (P> 0.05). The completion of nutrition treatment in group A was significantly lower than that in group B. In group A, only 40% of the target calories were completed on the first day and the second day after operation, and gradually improved on the third day after operation. In the seventh day after operation, Can complete the nutrition treatment plan; And group B from the first day after the operation can basically complete nutrition treatment plan. Prealbumin values ​​in group B were significantly higher than those in group A at 3 d, 5 d and 7 d after operation (P <0.05). The values ​​of urea nitrogen in the first day after operation were significantly higher than those before the operation (P <0.05), and remained stable at a high level in group A at the first day after operation. The level of urea nitrogen in group B slowly decreased to normal from the third day after operation. The body weight of children in group B was significantly higher than that in group A [(8.2 ± 1.2) kg vs. (6.8 ± 1.6) kg, P <0.05], and the postoperative length of stay in hospital was shorter than that in group A [(18.5 ± 10.1) d vs. 21.0 ± 11.4 d, P <0.05]. There was no significant difference in the total cost of hospitalization between the two groups (P> 0.05). Conclusion The treatment of enteral nutrition plus parenteral nutrition in infants after VSD repair is better than that of total enteral nutrition.