高龄胃癌患者术后早期肠内营养的临床研究

目的　探讨高龄胃癌患者术后早期肠内营养的可行性、安全性和临床疗效。方法　高龄胃癌患者 4 0例随机分为早期肠内营养 (EEN)组和完全肠外营养 (TPN)组 ,两组从术后第 1天到术后第 11天给予等热量、等氮量的营养支持 ,所有病例术前术后测体重、血清白蛋白、前白蛋白、转铁蛋白 ,外周血淋巴细胞计数 ,免疫球蛋白IgA、IgM、IgG ;临床观察生命体征、胃肠道功能恢复情况及各种不良反应。 结果　所有病例研究期无死亡、无严重并发症、无明显肝肾功能改变 ,EEN组较TPN组前白蛋白 (PA)和转铁蛋白 (TF)水平以及外周血淋巴细胞计数 (TLC)均明显升高 (P <0 0 5 ) ,TPN组体重、白蛋白下降较EEN组明显 ,体液免疫指标EEN组术后 11d基本恢复到术前水平 ,TPN组与术前相比尚有差异。结论　高龄胃癌患者术后早期应用肠内营养支持安全可行 ,既能改善营养状态 ,维护和促进胃肠功能 ,又能提高机体免疫功能

Clinical studies on early postoperative enteral nutrition in elderly patients after gastric cancer postoperation

Objective To evaluate the safety,feasibility and clinical effects of early EN(EEN) in postoperative elderly patients with gastric cancer.Methods 40 elderly patients after gastrectomy were randomly divided into EEN and TPN group,and two groups received iso-nitrogenous,iso-caloric nutritional support from the first day to the 10th day after operation.Serum albumin,immunoglobulin pre-albumin,transferrin and soon before operation and on the 11th day after operation were measured.The complications,vital signs and resumption of gastrointestinal functions were carefully observed and recorded simultaneously.Results Neither mortality nor serious morbidity occurred in all patients during the period of study,the concertrations of serum prealbumin and transferrin were significantly elevated ofter nutrional support in EEN group.THe lymphocyte count was also nigher in EEN group(P<0.05),weight loss and decrease of serum albumin were more significant in TPN group than those in EEN group.The indexes of immune function improved significantly in EEN group.Conclusion Postoperative EEN for gastric cancer is safe and feasible,not only improving nutritional status and maintaining gastrointestinal function,but also enhanced immunological function.