全胃切除术后早期肠内外营养的临床研究

目的探讨全胃切除术后早期肠外营养(TPN)与肠内营养(EN)的疗效。方法将因胃癌行全胃切除术的48例随机分为TPN组与EN组,每组24例。观察两组患者术后临床症状、并发症、平均住院时间、手术前后各组血清蛋白的变化及免疫功能状况指标。结果 EN组与TPN组比较术后肛门排气时间早、并发症低、住院时间短,两组比较差异有统计学意义(P<0.05);术后第3天及术后第14天,EN组的总蛋白、白蛋白、转铁蛋白水平明显高于TPN组(P<0.05);术后第7天两组CD4+T细胞、NK细胞、IgM、IgG均明显升高,两组比较差异有统计学意义(P<0.05)。结论全胃切除术后早期EN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。

Evaluation of early parenteral nutrition and enteral nutrition in totalgastrectomy

Objective To evaluate the efficacy of early parenteral nutrition and enteral nutrition in the patients of total gas- trectomy. Methods Forty-eight patients with total gastrectomy for gastric cancer surgery were randomly divided into groups of early parenteral nutrition and enteral nutrition group, 24 patients in eaeh group. Immune function index, complication rate and postoperative intestinal function recovery time and average hospital stay were observed. Results EN group and TPN group had early recovery time of postoperative anal exhaust, low complication rate, and short postoperative hospitalization time compared with the control group. There was significant difference between the two groups （ P 〈 0.05 ）. The total protein, albumin, transferrin level in EN group was significantly higher than that in the TPN group in postoperative day 3 and postoperative day 14 （P 〈 0.05 ）. CD4 ＋ T cells, NK cells, IgM, and IgG- were significantly increased in two groups on seventh day. A statistical significant difference was found between EN and TPN group （P 〈 0.05 ）. Conclusion Early EN total after gastrectomy are safe and effective nutritional support ways, which can quickly restored pa- tients immune status, shorten the intestinal function recovery time and the length of time.