胃癌全切术后早期肠内外混合营养与单纯肠外营养支持的疗效观察

目的探讨胃癌患者全胃切除术后早期肠内外混合营养和单纯肠外营养支持的临床疗效差异。方法回顾性分析我院2006年1月～2009年10月收治的144例老年胃癌手术患者,随机分为肠内外混合营养组（82例）和肠外营养组（62例）。比较观察两组患者不良反应及血清白蛋白（ALB）、转铁蛋白（TF）和前白蛋白（PA）、淋巴细胞总数（TLC）等临床指标的变化。结果混合营养组肺部感染和咽部不适发生率低于肠外营养组（P〈0.05）;而在切口感染、排气时间及住院时间的比较上,两组数据没有显著性差别（P〉0.05）。混合营养组的TLC、TF、PA等临床指标改善明显,与肠外营养组比较均有显著性意义（P〈0.05）。结论胃癌患者术后应用肠内外混合营养支持具有改善营养状态提高机体免疫水平,有利于减少术后肺部感染及咽部不适等并发症,对胃癌患者全胃切除术后恢复有重要意义。

Clinical observation of early enteral and parenteral nutrition and parenteral nutrition for gastric cancer with total gastrectomy

Objective To study the differences between enteral and parenteral nutrition support and enteral nutrition for gastric cancer with total gastrectomy.Methods Retrospectively analyzed 144 patiens with gastric cancer from Jan 2006 to Oct 2009.The 144 cases were randomly divided into 2 groups of 82 cases in the enteral and parenteral nutrition control group and 62 cases in common group.The values of ALB,TF,PA,TLC and the occurrence of complications was recorded.Results There were significant differences of TF,PA,TLC,P0.05,promoted the level of nutrition of patiens.Conclusion The application of the parenteral nutritional support is very important for gastric cancer patients with total gastrectomy to improve nutritional status,promote agglutination and reduce complications.Nutritional assessment and nutritional support is vital to reduce postoperative complications for patients with total gastrectomy.