胃癌术后患者早期肠内营养支持的临床价值

目的：探讨胃癌术后早期肠内营养支持的时机、安全性、可行性。方法：将51例胃癌胃大部切除手术患者随机分为肠内营养组（EN组,n=26）和肠外营养组（PN组,n=25）。肠内营养组（EN组）采用术中放置十二指肠营养管及胃肠减压管,术后12小时开始进行肠内营养。肠外营养组（PN组）采用术中仅放置胃肠减压管,术后常规＂三升袋＂静脉高营养。两组分别监测术后第1天、第10天患者的血清白蛋白、血清前白蛋白、血红蛋白、免疫球蛋白（A、G、M）、白细胞总数、早期胃肠道恢复时间、住院时间及平均住院费用等指标。结果：EN组术后血清白蛋白、血清前白蛋白、免疫球蛋白G水平较PN组恢复迅速,两者间有显著差异（P〈0.05）。EN组术后肛门排气排便时间较PN组缩短。EN组在缩短术后住院时间与减少住院费用方面也较PN组具有优势,差异显著（P〈0.01）。结论：胃癌术后早期肠内营养支持在时机上是安全、恰当、可行的,对改善术后早期机体营养状态具有显著作用,同时明显促进胃肠功能恢复,减少了患者住院时间与费用。

Clinical value of early enteral nutrition in postoperative gastric cancer patients

Objective：To investigate the effect of early enteral nutrition after subtotal gastrectomy.Methods：All 51 cases of gastric cancer after subtotal gastrectomy were randomly divided into two groups： Early enteral nutrition group（EN,n=26） and total parenteral nutrition group（PN,n=25）.The patients in EN were placed duodenum nutrition and gastrointestinal decompression tubes.And EN was given while operating after 12 hours of operation,only with a gastrointestinal decompression tube during operation,PN was given ＂three litre bags＂ intravenous nutrition after operation.The results were registered in monitor of postoperation first and tenth day＇s for serum albumin,serum prealbumin,hemoglobin,immunoglobulin,gastrointestinal recovery time and average hospitalization expense in the groups.Results：For recovery time of serum albumin,serum prealbumin,immunoglobulin G levels in EN,there were significant difference（P0.05） compared with PN.Comparing with PN,EN had advantages in hospital stay,hospitalization expenses and postoperative anal exhaust defecation time,there was also significant difference（P0.01）.Conclusion：After subtotal gastrectomy,EN is safe,appropriate,feasible for patients.It can greatly improve early postoperative nutritional status,promote the recovery of intestinal function,reduce hospital stay and hospitalization expenses.