胃癌根治术后早期肠内营养支持的临床疗效研究

目的探讨胃癌根治术后行早期肠内营养支持的临床疗效。方法将84例胃癌根治术后患者随机分为实验组和对照组,每组42例,实验组在术后24 h内给予早期肠内营养支持。两组术后48 h内均给予肠外营养支持。观察并比较两组患者的生化、营养和免疫指标、并发症、术后肠道通气时间、住院天数以及术后平均生存时间等指标。结果实验组患者术后第8天血浆前白蛋白水平高于对照组(P<0.05),并发症发生率低于对照组(P<0.01),术后肠道通气时间、排便时间、营养相关费用和住院天数均少于对照组(P<0.05)。实验组患者营养支持治疗后的血清CD3、CD4、CD4/CD8、CRP和IgM水平显著高于对照组患者营养支持后的水平(P<0.05)。两组患者三年随访期内的平均生存时间没有统计学差异(χ2=0.086,P=0.769)。结论胃癌根治术后行早期肠内营养支持有助于恢复肠功能,降低并发症发生率和提高患者免疫力。

Clinical efficacy of early enteral nutrition combined with parenteral nutrition in patients with gastric cancer receiving gastrotectomy

Objective To explore the effect of early enteral nutrition combined with parenteral nutrition after gastral surgery. Methods Eighty-four patients received gastral surgery were randomLy and equally divided into enteral nutri- tion combined with parenteral nutrition group （research group, n = 42） and parenteral nutrition group（control group, n = 42）. The early enteral nutrition supply were given to the patients within 24 hours after operation in research group and parenteral nutrition support was given to the patients from both groups within 48 hours after operation. The nutri- tional and immune indications, the time of postoperative bowel ventilation, hospitalization days and average survival time were observed and compared between the two groups. Results The prealbumin on the 8th day was higher in re search group than that in control group （P 〈 0.05） ; complication rate was lower than that in control group （P 〈 0.01 ） ; the time of postoperative bowel ventilation, the time of postoperative defecation, nutritional related costs and hospital- ization days were shorter or less than those in control group （P 〈 0.05）, The serum levels of CD3, CD4, CD4/CD8, CRP and IgM of patients from research group were significantly higher than that of patients from control group after corresponding nutritional support（P 〈 0.05）. No significant difference was found between the average sl~rvival time of patients from two groups in the three-year follow-up （X2=0.086,P = 0.769）. Conclusion The early enteral nutrition combined with parenteral nutrition after gastral surgery is feasible, safe and beneficial for the recovery of intestinal function with less complication.