肠内肠外营养支持对胃癌患者术后营养和功能状态影响的研究

目的观察肠内（EN）肠外营养支持（PN）对胃癌术后营养和功能状态的影响。方法 62例进展期胃癌,随机分为EN组和PN组各31例。比较两组术前及术后营养状况,功能状态,术后肠功能恢复时间。结果PN组术后第5、第8天总蛋白、清蛋白和前清蛋白水平均低于术前水平（P〈0.05）。EN组术后第8天血清总蛋白、清蛋白及前清蛋白与术前比较无显著差异（P〉0.05）;术后5 d EN组血清总蛋白前清蛋白水平高于PN组（P〈0.05）。术后第8天,EN组血清总蛋白、清蛋白和前清蛋白水平均高于PN组（P〈0.0 5）。EN组Karnofsky功能状态评分显著高于PN组（P〈0.0 5）;EN组体力状况分级为1～2级,PN组为2～3级。EN组肠功能恢复时间显著短于PN组（P〈0.05）。结论 EN有助于改善胃癌患者术后营养状况和功能状态,促进胃肠功能恢复,防治术后并发症。

Research on the effects of enteral and parenteral nutritional support on postoperative nutritional and functional status of gastric cancer patients

Objective To observe the effects of enteral and parenteral nutritional support on postoperative nutritional and functional status of patients with gastric cancer.Methods 62 cases of advancing gastric cancer were randomly divided into enteral（EN） and parenteral（PN） nutritional support groups,each 31 cases.And the preoperative and postoperative nutritional,functional status and postoperative recovery time of intestinal function were compared between two groups.Results In PN group,the serum levels of TSP,ALB,and PA at the fifth and eighth day after operation were lower than that of before operation（P0.05）.But no differences were observed in EN group before and after surgery.And at the eighth day after operation,the serum levels of TSP,ALB,and PA in EN group were higher than in PN group（P0.05）.The Karnofsky functional score in EN group was higher than that in PN group（P0.05）,and the physical status of patients in EN group（1～2 level） was also better than that in PN group（2～3 level）.Conclusion EN was more helpful to improve nutritional and functional status of postoperative patients with gastric cancer,and promote recovery of gastrointestinal function,prevent complications.