胃癌手术患者肠内营养治疗及肠道微生态调节的研究进展

胃癌是全球范围内发病率第5位、死亡率第3位的恶性肿瘤；对于有手术机会的胃癌患者主要的治疗方案仍是手术切除，由于胃癌患者精神心理因素、肿瘤消耗、机械梗阻、分解代谢增加等因素会导致患者严重的营养代谢问题，继而影响手术的安全性以及术后康复。外科手术是胃癌最主要的治疗方式，但由手术带来的创伤、生理结构的改变，以及术后的化疗则进一步加重上述问题。肠道微生态是人体免疫功能等重要组成部分，而现有研究提示肿瘤代谢、外科手术、化疗等均可能造成肠道菌群的改变。随着加速康复外科理念的发展，胃癌的综合治疗越来越为外科医生所重视。如何改善患者胃癌术后身体营养状况、减轻肠道菌群紊乱，进而减少术后并发症、加快术后康复，已成为胃肠外科医生关注的重点。本文主要通过文献回顾对行胃癌患者围术期肠内营养治疗及肠道微生态调节的应用进行综述。

Progress of enteral nutrition support and intestinal microecological adjustment in surgical patients with gastric cancer

Giastric cancer is the fifth malignant tumor in incidence and the third in mortality worldwide.For gastric cancer patients,the main treatment plan is still surgical resection.Due to psychological factors,tumor consumption,mechanical obstruction,increased catabolic metabolism and other factors of gastric cancer will lead to serious nutritional metabolism problems among patients,it will afct the safety of surgery and postoperative recovery.Surgery is the main treatment for gastric cancer,but the trauma,physiological changes and postoperative chemotherapy may further aggravate the above problems.Intestinal microecology is an important part of human immune function.However,existing studies suggest that tumor metabolism,surgery and chemotherapy may cause changes in the intestinal flora.With the development of the concept of accelerated rchabilitation surgery,the comprehensive treatment of gastric cancer has attracted more and more attention from surgeons.How to improve the nutritional status of patients with gastric cancer after surgery,reduce intestinal flora disorder,and thus reduce postoperative complications and accelerate postoperative recovery has become the focus of gastrointestinal surgeons.This paper reviews the application of perioperative enteral nutrition support and intestinal microcological regulation in patients with gastric cancer.