[Characteristics of metabolism and nutrition support during different periods in abdominal surgical diseases complicated by multiple organ dysfunction syndrome].

OBJECTIVE

To evaluate the characteristics of metabolism in patients with abdominal surgical diseases complicated by multiple organ dysfunction syndrome (MODS), and the effects of nutritional support in different periods.

METHODS

In 32 patients out of 66 patients suffering from MODS nutritional support was given through different channels according to different disease stages. In the first period, total parenteral nutrition (TPN) should be implemented when acute stress was just over and the functions of gastro-intestinal system was still in a bad condition. During the second period, TPN and enteral nutrition(EN) could be instituted at the same time, when the state of illness was under control. In the third period, if the condition of the patients was totally controlled, and the function of stomach and intestine had completely recovered, total EN could be given after a transitional period.

RESULTS

In these 32 patients, 23 patients were cured successfully and 9 patients died; the mortality was 28.12%. In those 34 patients treated with conventional methods, 19 patients were cured while 15 patients died, and the mortality was 44.11% (P<0.01).

CONCLUSION

When MODS occurred, metabolism is disturbed, and the body is unable to utilize the supplied nutrients and to get rid of the catabolic products. There fore, it seemed to be necessary to give nutrition support in different manner during different periods of the disease. Otherwise, the disease might be aggravated.