不同温度肠内营养液对胃癌根治术患者胃肠道并发症的影响

目的:探讨不同温度肠内营养液对胃癌根治术患者胃肠道并发症的影响。方法:选取2018—2019年江苏省中医院收治的胃癌根治术患者180例,依据随机数字表法分为低温组、体温组和高温组,每组60例。低温组患者给予低于体温(33.0~35.9℃)肠内营养液治疗,体温组患者给予接近体温(36.0~38.0℃)肠内营养液治疗,高温组患者给予高于体温(38.1~42.0℃)肠内营养液治疗。比较三组患者胃肠激素胃泌素(GAS)、胃动素(MTL)和胆囊收缩素(CCK)]水平、肠黏膜功能二胺氧化酶(DAO)、D-乳酸(D-LA)和乳果糖/甘露醇比值(L/M)]及胃肠道并发症发生情况的差异。结果:低温组、体温组及高温组患者治疗3、7 d后的GAS、MTL和CCK水平明显高于治疗前,体温组患者治疗3、7 d后的GAS、MTL和CCK水平明显高于低温组、高温组,上述差异均有统计学意义(P<0.05)。低温组、体温组及高温组患者治疗3、7 d后的DAO、D-LA和L/M水平明显低于治疗前,体温组患者治疗3、7 d后的DAO、D-LA和L/M水平明显低于低温组、高温组,上述差异均有统计学意义(P<0.05)。体温组患者胃肠道并发症发生率为10.00%(6/60),明显低于低温组的33.33%(20/60)和高温组的26.67%(16/60),差异均有统计学意义(P<0.05)。结论:接近体温(36.0~38.0℃)的肠内营养液可有效改善胃癌根治术患者胃肠激素及肠黏膜功能,有利于减少胃肠道并发症。

Effects of Enteral Nutrition Solution at Different Temperature on Gastrointestinal Complications in Patients Undergoing Radical Gastrectomy

OBJECTIVE:To probe into the effects of enteral nutrition solution at different temperature on gastrointestinal complications in patients undergoing radical gastrectomy.METHODS:Totally 180 patients undergoing radical gastrectomy admitted into Jiangsu Provincial Hospital of Traditional Chinese Medicine from 2018 to 2019 were extracted to be divided into the the low temperature group,body temperature group and high temperature group via the random number table,with 60 cases in each group.The low temperature group was treated with enteral nutrient solution below body temperature(from 33.0℃to 35.9℃),the body temperature group was treated with enteral nutrient solution close to body temperature(from 36.0℃to 38.0℃),and the high temperature group received enteral nutrient solution above body temperature(from 38.1℃to 42.0℃).Differences of gastrointestinal hormonesgastrin(GAS),motilin(MTL)and cholecystokinin(CCK)],intestinal mucosal functiondiamine oxidase(DAO),D-lactic acid(D-LA)and lactolose/mannitol ratio(L/M)]and the incidence of gastrointestinal complications of three groups were compared.RESULTS:After 3 and 7 d of treatment,the levels of GAS,MTL and CCK in the low temperature group,body temperature group and high temperature group were significantly higher than those before treatment,and the levels of GAS,MTL and CCK in the body temperature group were significantly higher than those in the low temperature group and high temperature group,with statistically significant difference(P<0.05).After 3 and 7 d of treatment,DAO,D-LA and L/M in the low temperature group,body temperature group and high temperature group were significantly lower than those before treatment,while DAO,D-LA and L/M in the body temperature group were significantly lower than those in the low temperature group and high temperature group,with statistically significant difference(P<0.05).The incidence of gastrointestinal complications in the body temperature group was 10.00%(6/60),significantly lower than 33.33%(20/60)in the low temperature group and 26.67%(16/60)in the high temperature group,the difference was statistically significant(P<0.05).CONCLUSIONS:Intestinal nutrient solution close to body temperature(from 36.0℃to 38.0℃)can effectively improve the gastrointestinal hormone and intestinal mucosal function in patients undergoing radical gastrectomy,which is beneficial to reduce gastrointestinal complications.