早期肠内营养对胃癌术后患者营养状况和肠功能的影响

目的：探讨胃癌病人术后早期肠内营养对机体营养状况和肠功能的影响。方法：选择胃癌根治性手术病人60例,随机分为两组：早期肠内营养组30例,于术后24 h应用瑞素进行早期肠内营养,共实施7 d;肠外营养组30例,术后给予全肠外营养治疗。两组病人分别于手术前1 d、术后第1、8天检测营养指标血清清蛋白（ALB）、转铁蛋白（TF）和前清蛋白（PA）,并观察肠功能恢复时间。结果：术后第1天两组患者血清清蛋白、转铁蛋白和前清蛋白浓度较术前有明显下降（P〈0.05或0.01）,经过一段时期的肠内营养和肠外营养支持后基本恢复到术前水平,肠内营养的营养恢复作用与肠外营养相比无明显差异。肛门排气/排便时间两组病人差异显著（P〈0.01）。两组病人在观察期间均未发生严重并发症。结论：术后早期肠内营养支持可以改善胃癌病人的营养状况,促进肠蠕动恢复的作用优于肠外营养。

Effect of early enteral nutrition on nutritional status and bowel function of gastric cancer surgical patients

Objectives: To investigate nutritional status and bowel function effect of early enteral nutrition(EEN) in surgical patients with gastric cancer. Methods: Sixty postoperative patients with gastric cancer were randomly divided into EEN group and parental nutrition(PN) group.The patients in EEN group received RUISU early enteral nutrition from postoperative day 1 to postoperative day 7.The patients in PN group received total parental nutrition.ALB,PA,TF were detected on the day before the operation and the postoperative days 1 and 8.And the restoring time of intestinal movement was observed.Results: On the 1 day postoperatively,ALB,TF,PA in two groups decreased significantly(P<0.05,P<0.05,P<0.01).On the 8th day,there were no significant differentce in ALB,PA,PF in EN-group than in PN-group(P>0.05).The restoring time of bowel movement was significantly decreased in the EN group compared with PN group after operation(P<0.01).In both EEN group and PN group there were no serious complications.In both EEN group and PN group there were no serious complications. Conclusions: Early enteral nutrition can improve nutritional status,and compared with the parental nutrition,early enteral nutrition can promote the recovery of bowel function in gastric cancer surgical patients.