探讨腹部手术患者术后肠内营养策略对改善患者预后和临床结局方面的临床价值，为临床治疗提供依据。

回顾性分析2008年1月至2012年12月宝鸡市人民医院接受腹部手术治疗的患者100例。根据患者肠内营养策略分为早期组（60例，<48 h）和延迟组（40例，≥ 48 h），详细观察及记录APACHE Ⅱ评分、GCS评分、糖尿病及高血压病史、手术类型、有无接受肠外营养支持、无需机械通气天数、肠内营养起始时间、软质饮食开始天数、住院天数、感染及死亡病例数量、血液细菌培养结果、尿培养结果、真菌培养结果、深层气管内培养结果、脓液培养结果、是否静脉注入辅助营养支持等指标，并比较上述指标在两组中的差异及相关性。

两组患者在性别、年龄、APACHE Ⅱ和GCS评分、是否伴有糖尿病或高血压、紧急和不紧急手术类型、腹腔镜和开放性手术类型方面差异无统计学意义；延迟组在吻合口手术、接受肠外营养的患者比例高于早期组，差异有统计学意义（χ²=5.02、8.72，P=0.03、<0.01）。腹部手术患者临床特征方面，早期组在无需机械通气天数、肠内营养起始时间、软质饮食开始天数、住院天数、感染病例数量方面均低于延迟组，差异有统计学意义（χ²=5.81，t=3.56、4.26、5.27、6.58，均P<0.05）。相关性分析显示肠内营养起始时间与住院天数呈正相关（r=0.59，P<0.05）。

早期肠内营养支持能有效降低腹部手术患者术后感染风险，但对改善预后方面或许无临床价值。

To investigate the clinical value of enteral nutrition strategy on clinical prognosis and outcome of patients with abdominal surgery, and to provide evidence for clinical treatment.

From January 2008 to December 2012, one hundred patients received abdominal surgery in Baoji People’s Hospital. According to the strategy of enteral nutrition, the patients were divided to early group (60 cases, <48 h) and delayed group (40 cases, ≥48 h). Clinical indexes such as APACHE Ⅱ score, GCS score, diabetes and hypertension history, type of surgery, parenteral nutrition support, ventilator free days, initial time of enteral nutrition, soft diet time, hospital stay, number of infections and deaths, results of blood and urine bacterial culture, fungi culture, deep tracheal culture, pus culture, whether intravenous injection for nutritional support, were recorded and compared. The correlation between the two groups were also analyzed.

In terms of abdominal surgery in patients with general information, the two groups were not significantly different in sex, age, APACHE Ⅱ score, GCS score, whether or not differences with diabetes or hypertension, emergency and emergency surgery, laparoscopic and open surgical operation type. There was significant difference between the two groups in terms of the type of operation and whether or not they received parenteral nutrition (χ²=5.02, 8.72, P=0.03,<0.01). In the early group, ventilator free days, initial time of enteral nutrition, soft diet time, hospital stay, the number of infection cases were significantly lower than those in the delayed group (χ²=5.81, t=3.56, 4.26, 5.27, 6.58, all P<0.05). Correlation analysis showed that the initial time of enteral nutrition was positively correlated with hospital stay (r=0.59, P<0.05).

Early enteral nutrition support can effectively reduce the risk of postoperative infection in patients undergoing abdominal surgery, but may not be of clinical value in improving prognosis.