延期留置空肠造口管间断肠内营养在进展期胃癌术后辅助化疗中的应用评价

目的 研究延期留置空肠造口管间断肠内营养在进展期胃癌术后辅助化疗中应用的可行性及疗效.方法 将进展期胃癌术后行辅助化疗的82例患者按机械抽样法随机分成A、B两组,每组各41例.均于术中放置空肠造口管,A组延期留置空肠造口管至化疗6个疗程结束,每个化疗疗程经空肠造口管给予肠内营养液;B组于化疗前拔除空肠造口管,每个化疗疗程给予普通饮食.比较化疗后两组营养及免疫指标,观察延期留置空肠造口管相关并发症.结果 化疗后A组血红蛋白(106.9±12.0)g/L]、血清白蛋白(26.2±1.4)g/L]、前白蛋白(202.9±32.2)mg/L]及IL-2(11.9±2.1)μg/L]、NK细胞活性(21.3±5.2)%]、CD:(62.9±3.3)%]、CD4+(26.1±4.7)%]、CD4/CD8(1.1±0.2)水平显著高于B组(P＜0.05或＜0.01);化疗期间A组呕吐发生率(4.9%,2/41)显著低于B组(26.8%,11/41),平均每日摄入量(1312±114)ml]显著多于B组(765±186)ml](P＜0.05).延期留置空肠造口管未发生相关严重并发症.结论 延期留置空肠造口管间断肠内营养在进展期胃癌术后辅助化疗中应用是安全可行的,可以有效地提高术后辅助化疗患者的营养及免疫状况.

Application of enteral nutritional support by needle catheter jejunostomy feeding tube during postoperative adjuvant chemotherapy of staged gastric cancer

Objegtive To study the feasibility and clinical effects of enteral nutrition by needle catheter jejunostomy(NCJ)tube in the postoperative adjuvant chemotherapy for patients of staged gastric cancer.Methods Eighty-two patients with staged gastric cancer underwent radical gastrectomy and going to receive chemotherapy were randomly divided into group A(41 cases)and group B(41 cases).All of the patients had been NCJ.Group A received enteral nutrition through the tube during chemotherapy,and group B had been given general diet.A series of parameters were measured post-chemotherapy.And the gastrointestinal complications were carefully observed.Results In post-chemotherapy,the level of hemoglobin,albumin,prealbumin,interleukin-2,natural killer cell activities and CD3+,CDd4+,CD4/CD8 in group A(106.9±12.0)g/L,(26.2±1.4)g/L,(202.9±32.2)mg/L,(11.9±2.1)μg/L,(21.3±5.2)%,(62.9±3.3)%,(26.1±4.7)%,1.1±0.2]were significantly higher than those in group B(P＜0.05 or＜0.01).The incidences of vomiting in group A(4.9%,2/41)was significantly lower than that in group B (26.8%,11/41)(P＜0.05).The average intake in group A(1312±114)ml]was significantly more than that in group B(76.5±186)ml](P＜0.05).No severe enteral nutrition related complications occurred in group A.Conclusions It is safe and feasible to enteral nutrition supported by NCJ tube in chemotherapy for patients of staged gastric cancer.It can improve the nutrition status and immune function in the given patients.