胃癌手术后出院患者早期行肠内营养干预对其营养指标的影响

目的：分析早期肠内营养支持对胃癌术后出院患者营养指标及其恢复的影响。方法随机抽取2011年5月至2015年4于我院择期行胃癌根治术治疗的74例患者作为研究对象，按住院顺序编号，以随机数字表法分为A、B两组，每组各37例。A组胃癌术后早期作家庭肠内营养干预，B组未给予家庭肠内营养支持，比较两组患者术后胃肠道指标的恢复情况，以及出院前后不同时间段患者血清前蛋白(PA)、白蛋白(ALB)、免疫球蛋白(IgG、IgA、IgM)、血红蛋白(Hb)及白细胞计数（WBC）等指标的变化，同时比较两组患者的体质量(BW)、并发症和出院后生活质量改善情况。结果出院3周后，A组患者的PA、ALB、HGB、BW分别上升至(0.25±0.06) g/L、(38.65±3.84) g/L、(93.21±10.41) g/L、(65.06±10.44) kg，IgG、IgA分别上升至为(13.01±1.81) g/L、(4.11±0.97) g/L，分别与B组比较，差异均有统计学意义(P<0.05)；A组患者出院3周KPS评分为(86.86±5.94)分，明显高于B组的（80.36±2.78）分，差异均有统计学意义(P<0.05)；A、B组患者术后并发症发生率分别为13.51%(5/37)、18.92%(7/37)，差异无统计学意义(P>0.05)。结论采用早期家庭肠内营养支持干预胃癌术后出院患者，可改善患者出院后营养指标、免疫水平，改善其术后生活质量，且安全性高。

Effect of early enteral nutrition intervention on nutritional indexes of discharged patients with gastric cancer after surgery

Objective To analyze the effects of early enteral nutrition intervention on nutritional indexes and recovery in discharged patients with gastric cancer after surgery. Methods Seventy-four patients who underwent radi-cal gastrectomy in our hospital from May 2011 to April 2015 were selected as the study subjects. According to the order of admission, they were divided into group A and group B by the random number table, with 37 patients in each group. Group A was given early home enteral nutrition intervention after operation, while group B was not given home enteral nutrition support. The postoperative recovery of gastrointestinal indexes, changes of serum pre-albumin (PA), albumin (ALB), immunoglobulin (IgG, IgA, IgM), hemoglobin (Hb) and white blood cell count (WBC) were compared between the two groups in different time periods before and after discharge. Body weight (BW), incidence of complications and improvement of quality of life after discharge were compared between the two groups. Results At 3 weeks after dis-charge, PA, ALB, HGB and BW in group A were increased to (0.25±0.06) g/L, (38.65±3.84) g/L, (93.21±10.41) g/L and (65.06 ± 10.44) kg, respectively, and IgG and IgA were increased to (13.01 ± 1.81) g/L and (4.11 ± 0.97) g/L, respectively, all showing statistically significant differences with those in group B (P<0.05). The KPS score of group A at 3 weeks af-ter discharge was significantly higher than that of group B, (86.86±5.94) vs (80.36±2.78), P<0.05. The incidence of post-operative complications in group A and group B were 13.51%and 18.92%, respectively, with no statistically significant differences (P>0.05). Conclusion Using early home enteral nutrition intervention in discharged patients with gastric cancer after operation can improve the nutritional indexes, immune level and the postoperative quality of life, with good safety.