低热量肠内营养联合肠外营养对消化道肿瘤术后的临床疗效分析

目的考察低热量肠内营养联合肠外营养对消化道肿瘤术后的临床辅助疗效。方法回顾浙江省宁波市第二医院2008年3月-2012年7月收治的消化道肿瘤患者的临床诊治资料，筛选150名消化道肿瘤患者为研究对象。对照组和实验组分别为75名，对照组给予单独的肠外营养治疗，实验组给予低热量肠内营养和肠外营养的联合治疗。对两组患者治疗过程中的营养状况、免疫状况和并发症发生率等方面进行对比评价，考察两种治疗方案的疗效差异。结果在营养状况方面，实验组患者术后1、7、10d的白蛋白、转铁蛋白等水平均高于对照组，且差异均有统计学意义（P〈0．05）。在免疫状况方面，实验组患者术后1、7、10d的IgA、IgM等免疫指标的水平均高于对照组，且差异有统计学意义（P〈0．05）。此外，在住院时间、肠道功能恢复时间、体重变化以及合并症发生率等方面，实验组也优于对照组[（8．00±1．67）d比（12．00±1．83）d，（53．2±5．4）h比（74．1±5．9）h，（2．81±0．32）％比（3．12±0．84）％，9．33％比34．67％]，且差异有统计学意义（P〈0．01或P〈0．05）。结论低热量肠内营养联合肠外营养能够有效加速消化道肿瘤患者术后的康复进程，降低合并症的复发率，具有较大的临床推广意义。

Clinical effect analysis of gastrointestinal tumors after surgery by hypocaloric enteral nutrition combining with parenteral nutrition

Objective To observe the clinical auxility effects of gastrointestinal tumors after surgery by hypocaloric enteral nutrition combining with parenteral nutrition. Methods Clinical diagnosis and treatment data of patients with gastrointestinal tumors admitted into the Second Hospital of Ningbo from March 2008 to July 2012 were reviewed, and 150 patients were se- lected as research objects. They were randomly divided into control group and experiment group. In the control group, only parenteral nutrition therapy was provided, while in the experiment group, the combination therapy of hypoclaoric enteral nutri- tion and parenteral nutrition was applied. The nutritional status, immune state, and incidence of complications in the process of treatment in both groups were comparatively analyzed in order to observe the effect differences between the two therapeutic regimens. Results In the aspect of nutritional status, the levels of albumin and transferrin 1, 7, 10 d after surgery in the experiment group were all higher than those in the control group with statistical differences （P 〈 0.05）. In the aspect of immune state, the values of immunity indexes like IgA and IgM for 1, 7, 10 d after surgery in the experiment group were much higher in comparison with those in the control group, which displayed statistical differences （P 〈 0.05）. Besides, the hospital stay, recovery time of intestinal function, body weight change in the experiment group were （8.00±1.67） d, （53.2±5.4） h, and （2.81± 0.32）% respectively, and those in the control group were （12.00±1.83） d, （74.1±5.9） h, and （3.12±0.84）% in turn. The abovementioned parameters and incidence of complications in the experiment group （9.33%） were superior to those in the control group （34.67%） with statistical differences （P 〈 0.01 or P 〈 0.05）. Conclusion The combination of hypocaloric enteral nutrition and parenteral nutrition can effectively accelerate postoperative recovery process of patients with gastrointestinal tumors and reduce the recurrence rate of complications, which has a great significance on clinical expansion.