早期肠外营养与肠内营养在全胃切除术中的疗效观察

目的探讨全胃切除术早期肠外营养与肠内营养的疗效。方法将86例因胃癌行全胃切除术的患者随机分为早期肠外营养组与肠内营养组，每组43例。观察两组患者免疫功能状况指标、并发症发生率及术后肠道功能恢复时间和平均住院时间。结果肠内营养组TLC、TRF、CD4、CD8营养后均较肠外营养组明显升高，两组比较有显著性差异（P均〈0．05）；两组Alb、IgG、IgM、C3营养后均较营养前有所提高，但营养前后比较无显著性差异（P〉0．05）。肠内营养组腹泻、腹涨、恶心等不良反应的发生率为23.3％，较肠外营养组的37．2％低（P〈0．05）。肠内营养组术后肠道功能恢复时间、平均住院时间均低于肠外营养组（P均〈0．05）。结论全胃切除术后早期肠内营养是安全、有效的营养支持途径，可迅速恢复患者的免疫状态，缩短肠道功能恢复时间和住院时间。

Efficacy of Early Parenteral Nutrition and Enteral Nutrition in Total Gastrectomy

Objective To evaluate the efficacy of early parenteral nutrition and enteral nutrition in the patients of total gastrectomy. Methods Eighty-six patients with total gastrectomy for gastric cancer surgery were randomly divided into groups of early parenteral nutrition and enteral nutrition group, 43 patients in each group. Immune function index, complication rate and postoperative intestinal function recovery time and average hospital stay were observed. Results The TLC, TRF, CD4, CD8 after nutrients in enteral nutrition group was significantly higher than that in the parenteral nutrition respectivly （ P 〈 0.05 ）. Alb, IgG, IgM, C3 nutrition increased after nutrition, but there was no significant difference between after and before nurition （ P ~ 0.05 ）. Adverse reactions including diarrhea, abdominal distention, nausea etc in the enteral nutrition group was 23.3%, lower than that of the parenteral nutrition group （ 37.2% ）（ P 〈 0.05 ）. Intestinal function recovery time, mean hospital stay in the enteral nutrition were lower than in the parenteral nutrition group respectivly （ P 〈 0.05 ）. Conclusion Early enteral nutrition after gastrectomy is safe, effective nutritional support avenues for rapid recovery of the immune status of patients and can shorten the time of bowel function recovery and hospital stay.