胃癌腹腔镜术后早期肠内营养的效果评价

目的 对比分析腹腔镜术后早期肠内营养和开放手术后肠外营养对机体恢复情况和免疫功能的影响.方法 将60例胃癌患者随机平均分为两组,观察组行腹腔镜远端胃大部切除术和早期肠内营养,对照组行开放手术和肠外营养.比较分析两组患者术后营养支持期间的肠胃功能恢复情况、营养状况、免疫功能和住院天数.测定术前和术后1天、7天的肝功能、电解质、营养指标（体重、血清总蛋白、血清清蛋白、前清蛋白）和免疫指标（外周血CD4、CD8、CD4/CD8）.结果 观察组患者术后排气时间短于对照组（P＜0.05）;术后第7天肝功能损害比对照组轻,而血清前清蛋白、CD4、CD4/CD8均高于对照组（P＜0.05）;术后平均住院时间少于对照组.结论 腹腔镜手术和早期肠内营养有利于胃癌患者术后的肠胃功能恢复,对改善机体营养状况和促进免疫功能恢复具有积极意义,能缩短术后住院天数.

Clinical evaluation of early enteral nutrition after laparoscopic gastrectomy for gastric cancer

Objective To compare the body recovery and effect on immune function between panents with early enteral nutrition after laparoscopic assisted surgery and total parenteral nutrition after open surgery. Methods A total of 60 patients were divided into two groups randomly. The observational group underwent laparoscopic distal stomach gastrectomy and early enteral nutrition; while the control group underwent open surgery and parenteral nutrition. Gastrointestinal function recovery, nutritional status, immune function and postoperative hospitalization days during postoperative nutritional support were com- pared and analyzed. Liver function, electrolytes, nutrition indicators （body weight, serum total protein, serum albumin, and prealbumin） and immune parameters （peripheral blood CD4, CD8, and CD4/CD8） were measured at preoperative day 1 and postoperative day l＆7. Results Compared with the control group, the exhaust time of observational group was shorter, the liver damage of observational group was lighter at postoperative day 7; but the serum albumin, CD4, and CD4/CD8 of observa- tional group were higher （P〈0.05）. Moreover, hospitalization day of the observational group was less than the control group. Conclusion Laparoscopic assisted surgery and early enteral nutrition are conducive to gastrointestinal function recovery, im- provement of nutritional status, recovery of immune function, and to shorten the hospital days.