胃癌术后早期瑞素肠内营养对患者机体营养状况的影响

目的]探讨早期瑞素肠内营养对胃癌患者术后机体营养状况的影响.方法]选取我院和新疆医科大学附属肿瘤医院2010年1月～8月胃癌根治性手术患者60例,随机分为两组:早期肠内营养组和完全肠外营养组,每组30例.早期肠内营养组于术后24h施行早期瑞素肠内营养,完全肠外营养组于术后24h术后给予常规完全肠外营养输液治疗.两组患者共接受7天营养支持治疗及临床观察,分别于手术前1d、术后第1d与第8d检测营养指标,肝肾功能指标,并观察肠功能恢复时间.结果]选取我院和新疆医科大学附属肿瘤医院2010年1月～8月胃癌根治性手术患者60例,随机分为两组:早期肠内营养组和完全肠外营养组,每组30例.早期肠内营养组于术后24h施行早期瑞素肠内营养,完全肠外营养组于术后24h术后给予常规完全肠外营养输液治疗.两组患者共接受7d营养支持治疗及临床观察,分别于手术前1d、术后第1d与第8d检测营养指标,肝肾功能指标,并观察肠功能恢复时间.结论]早期瑞素肠内营养能明显改善胃癌患者术后的营养状况,促进患者胃肠功能及全身机能的早期恢复.

Nutritional effects of early Enteral fresubin nutrition on the postsurgical patients with gastric cancer

Objective] To investigate the nutritional effects of early Fresubin enteral nutrition on the postsurgical patients with gastric cancer. Methods ] Sixty postsurgical patients with gastric cancer were randomly divided into early enteral nutrition （EEN） group and parenteral nutrition （PN） group. Starting at the day 1 post surgery, the subjects in EEN group received early Fresubin enteral nutrition, whereas the subjects in CPN group received conventional total parental nutrition for 7 days. At the day before surgery and the day 1 and day 8 post surgery, we collected the blood samples from the all subjects and measured plasmid albumin （ALB）, prealbumin （PA）, transferring （TF）, unconjugated bilirubin （UCB）, conjugated bilirubin （CB）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, serum creatinine （CREAT）, and blood urea nitrogen （BUN）. We also monitored clinical demographics and illness severity parameters. Results] Plasma ALB, PA, and TF were significantly decreased in the two groups at the day 1 post surgery versus before surgery （P 〈 0.05）, but no significant difference in the two groups at the day 8 post surgery. Additionally, no significant difference was observed for UCB, CB, ALT, AST, CREAT, and BUN between two groups before and after nutrition administration. However, the subjects in EEN group showed significantly shorter time in restoring bowel movement compared to the subjects in the PN group post surgery （P 〈 0.01）. Conclusion] In VPC from RVOT the width of R wave in lead Ⅱ, Ⅲ, AVF was sensitive to localize VPC from free wall or septal. QRS configuration in lead I was of use to distinguish VPC from anterior or posterior part within RVOT. The amplitude of R wave in leadn, m, AVF combined with R/S transition in precordial lead could predict VPC adjacent to pulmonary valve or tricuspid valve.