全胃切除术后早期肠内肠外营养的对比研究

目的：探讨全胃切除术后早期肠内营养（EEN）与全肠外营养（TPN）对患者营养状况的改善及并发症发生率的影响。方法：将86例接受根治性全胃切除的胃癌患者随机分为EEN组和TPN组。EEN组手术后第1天开始分别给予营养支持，于术前1天、术后8天检测体重、血常规、肝功能、前白蛋白和C-反应蛋白，并观察并发症的发生率和平均住院费用。结果：EEN组体重、白蛋白、前白蛋白下降幅度和白细胞、转氨酶、C-反应蛋白升高幅度均少于TPN组。EEN组患者吻合口瘘、肺部感染、切口愈合不良等并发症发病率低于TPN组。EEN组的平均住院费用低于TPN组。结论：术后EEN较TPN能改善全胃切除术后患者的营养状况，降低并发症发生率，减少经济费用。

Comparative study of postoperative early enteral nutrition and parenteral nutrition in total gastrectomy

Objective： to explore the effect of postoperative early enteral nutrition （EEN） and total parenteral nutrition（TPN） on nutritional status and complications in total gastrectomy. Methods： 86 patients with radical total gastrectomy were randomly divided into two groups, and received EEN （n=43）or TPN （n=43） continuously for 7 days after operations. 8 days later,the body weight, blood routine test, liver function, prealbumin and C-reactive protein were compared with those before operation, complications and the costs were also compared. Results： The body weight, albumin, prealbumin decreased less in EEN group than those in TPN group. Meanwhile, the WBC count, transaminase and C-reactive protein increased less in EEN group than those in TPN group. The complication rates of anastomotic fistula, pulmonary infection and delayed incision healing were 0, 7.0% and 0 in EEN group, and 2.3%, 20.9% and 11.6% in TPN group. There were significant differences between the two groups （P〈0.01）. The costs in EEN group were significant less than those in TPN group （P〈0.01）. Conelusion： Early postoperative enteral nutrition after total gastrectomy can improve nutritional status and reduce complications and the medical costs in comparison with total parenteral nutrition.