EN对胃癌根治术后禁食病人血浆内毒素水平的影响

目的评价肠内营养（EN）对胃癌根治术后禁食病人血浆内毒素水平的影响.方法 70例因胃癌行全胃切除术病人随机分为EN组和肠外营养（PN）组,各35例,分别给予管饲EN和外周PN支持,测定治疗前、治疗后第1、3、7天血浆中的内毒素水平变化.结果术前和术后第1天,EN和PN组内毒素水平无显著性差异（t=0.539,P〉0.05）,术后第3、7天两组血浆内毒素水平较术前增高,差异有显著性（F=18.910、26.528,P〈0.001）;术后第3、7天,EN组内毒素水平低于PN组,差异有显著性（t=2.013、2.867,P〈0.05、0.01）.结论相对于PN而言,EN可减少胃癌根治术后禁食病人的内毒素移位.

INFLUENCE OF POSTOPERATIVE ENTERAL NUTRITION ON ENDOTOXIN LEVELS IN PATIENTS UNDERGOING RADICAL GASTRECTOMY FOR GASTRIC CANCER

Objective To evaluate the effect of enteral nutrition(EN) on endotoxin levels in patients undergoing radical gastrectomy for gastric cancer.MethodsSeventy patients were randomly assigned to two equal groups.Those in group 1 were supported with postoperative enteral tube feeding,while those in group 2 with parenteral nutrition(PN).The plasma endotoxin levels were detected before operation and one,three and seven days after operation.ResultsNo difference was observed between the two groups preoperatively and on the first postoperative day in the plasma levels of endotoxin(t=0.539,P>0.05).At three and seven days after surgery,both groups showed increased levels of endotoxin(F=18.910,26.528;P<0.001).However,EN group demonstrated relatively low level of endotoxin compared with PN group on the 3rd and 7th postoperative day(t=2.013,(2.867);P<0.05,0.01).ConclusionWith regard to parenteral nutrition,enteral nutrition may reduce endotoxin transfer in fasting patients after radical gastrectomy.