肠内营养对胃癌术后恢复的影响

目的:观察胃癌根治术后早期肠内营养的临床疗效及评价其安全性、可行性。方法:对本院普外科收治的60例胃癌手术患者治疗作回顾性分析,随机分成对照组(共30例)和肠内营养(Enteral Nutrition,EN)组(共30例)。对照组术后常规处理,EN组术后24~48h开始经空肠营养管滴注肠内营养液共7d,两组营养支持均等热量、等氮量,术后8d进行人体相关指标测量,进行支持前后自身对照及组间比较。观察两组患者术前和术后的营养状态、肠功能恢复情况、住院时间及住院费用等。结果:EN组除1例因腹胀明显不耐受外均按计划完成治疗,治愈出院,EN组和对照组在并发症比较上差异无显著性,EN组肠功能恢复时间早于对照组,但两组排便功能的恢复无显著差异(P>0.05),术后8d两组体重均明显减轻(P<0.01),而术前、术后白蛋白的改变无显著差异(P>0.05),EN组住院时间及营养费用少于对照组。结论:胃癌根治术后早期肠内营养安全、简便、经济,优于肠外营养。与TPN支持相比,EN有利于促进患者的胃肠功能及营养状况恢复,胃癌根治术后EEN支持是安全可行的,是合理、有效的营养支持方式;患者营养状态恢复快、对肝功能影响小。

The Effect of Enteral Nutrition in Patients with Gastric Carcinoma After Operation

Objective：To estimate the security and feasibility of early enteral nutrition in patients which have received gastrectomy of gastric cancer.Methods： 60 patients with postoperative gastrectomy of gastric cancer were observed and divided into two groups as whether they used enteral nutrition（EN） or not.The EN group were given nutrition support with Peptison Liquid at 24~48 hours after operation from jejunostomy tude which inserted in the jejunum during the operation.The course were continued for 7 days.The control group were treated with conventional methods,with equal calories and nitrogen.After 8 days human-related indicators were measured before or after nutrition in the self-control and among the two groups.Anthropometric,albumin level and gastrointestinal functions were monitored.Results： All compared each other with the days and the fee in hospital,the bowel movement,nutrition et al.All cases were discharged in a good condition on schedule,except one case in EN group discontinued because of intolerance to obvious abdominal distension.While the patients passed stool were no significant change in both groups（P0.05）.When it was compared in 8 days postoperatively with that in preoperation,the weight of the patients decreased significantly（P0.01）.No difference was found in albumin level in the two groups（P0.05）.Conclusion： EEN support is a safe,practicable,reasonable and effective method for postoperative patients with gastric cancer.Compared with TPN support,it helps patients to restore nutritional status,less effect the liver function.It also helps patients recover flatus functional and shortens the length of stay and lower the cost.