胃癌患者术后肠内营养与肠外营养效果比较

目的观察肠内营养（EN）与肠外营养（PN）对胃癌患者术后临床恢复的影响。方法PN组术后每日行完全肠外营养支持直到经口进食。EN组术后第1d以静脉支持为主，第2d开始经空肠造瘘管滴入肠内营养制剂能全力，逐步加大支持强度并减少静脉支持。观察两组术后排气排便时间、并发症发生率、体质量、血红蛋白（HGB）、血清前白蛋白（PALB）和外周血淋巴细胞计数（LY）。结果EN组术后排气、排便时间和术后平均住院时间均短于PN组。术后第7dEN组各项指标的恢复速度均优于PN组。EN组术后并发症发生率为25．00％（5／20），明显低于PN组45．00％（9／20）。结论胃癌术后早期EN支持可促进小肠运动功能恢复，加快免疫和营养状态改善，降低并发症发生率。

Effects of enteral nutrition and parenteral nutrition for patients with gastric carcinoma after operation

Objective To observe the clinic outcome of the patients with gastric carcinoma treated by enteralnTutrition （EN） or parenteral nutrition （PN） after operation. Methods Those of parenteral nutrition （PN） group were given total parenteral nutritional supports as routinely started from the 1 st postoperative day until oral feeding, Patients of the enteral nutrition（EN） group were given parenteral nutritional supports routinely on the 1st day , then with all strength to drip in nutrition fibre through the jejunal fistula beginning from the second postoperative day , to strengthen the intensity of support and to reduce the venous support gradually. The observation indices included the flatus passing and defecation time, morbidity, body weight changes , hemoglobin level , plasmaalbumin level and peripheral blood lymphocyte count. Results The time of breaking wind and of bowel movement ,and of hospital stay after operation in the EN group was shorter than that of the PN groupl In the first seven days after surgery , various parameter recovery rates in group EN were better than those in group PNI The postoperative complicatiomate of group EN was 25. 00%, significantly lower than that in PN （45.00%） . Conclusion Early postoperative enteral nutrition support can promote the recovery of intestinal motor function , improve the nutritional status and immunity and reduce the incidence of complications.