摘要
目的 比较胃癌全胃切除术早期肠外营养与肠内营养的疗效。方法 将40例因胃癌行全胃切除术的患者随机分为早期肠外营养组与肠内营养组,每组20例。观察两组患者手术前后营养、免疫状况变化,术后并发症发生率及肠道功能恢复时间和平均住院时间等。结果 肠内营养组的平均首次排便时间和术后肠道功能恢复时间均显著早于肠外营养组（t=5.091、7.007,均P〈0.05）,肠内营养组的住院时间也显著短于肠外营养组（t=5.802,P〈0.05）。共有32.5%（13/40）的患者出现了术后并发症,其中肠内营养组3例（30%）,肠外营养组7例（35%）,两组差异有统计学意义（χ2=6.970,P〈0.05）。术后两组患者的营养状况均逐渐下降,至术后7 d后开始缓慢回升。肠内营养组患者体质量逐渐下降至术后14 d,术后21 d开始体质量迅速恢复,肠外营养组患者于术后90 d时体质量仍在下降。两组患者的前白蛋白和转铁蛋白含量均于术后7 d开始缓慢恢复,但是肠内营养组的恢复速度显著比肠外营养组快（前白蛋白：t=9.501、7.913、7.182、6.154,均P〈0.05;转铁蛋白：t=5.501、5.712、5.733、5.801,均P〈0.05）。术后7 d时两组患者的淋巴细胞计数（TLC）、CD4和CD8指标均低于术前,至术后14 d时均已恢复至术前水平,但第7、14天时肠内营养组的TCL指标均显著高于肠外营养组（t=5.645、5.134,均P〈0.05）。PG-SGA评分肠内营养组低于肠外营养组,而且在手术后21 d时两组差异有统计学意义（t=5.211,P〈0.05）。结论 全胃切除术后早期肠内营养是安全、有效的营养支持途径,对伤口愈合无负面影响,并能明显改善患者的营养状态和免疫功能,提高患者蛋白质代谢水平,有效促进术后肠功能的恢复,有利于患者全面恢复。
Objective To compare the effect of comparion of the effect of postoperative.Methods Forty patients with total gastrectomy for gastric cancer surgery were randomly divided into groups of early parenteral nutrition（EEN） and total parental nutrition （TPN） group,20 patients in each group.Nutritional index,immune status,complication rate and postoperative intestinal function recovery time and average hospital stay were observed.Results The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than that in TPN group（t=5.091,7.007,all P〈0.05）.and the hospital stays of EEN group all so significantly shorter than TPN group （t=5.802,P〈0.05）.Prealbumin and transferrin were significantly reduced on post-operative day（POD） 7 and were slowly recovered until POD 90.but the increased rate in EEN group was significantly faster than that in TPN group [cprealbumin：t=9.501,7.913,7.182,6.154,all P〈0.05];transferrin：t=5.501,5.712,5.733,5.801,all P〈0.05）.The TLC,CD4 and CD8 are lower than before total gastrectomy on POD 7,and have been recovered to the level before surgery.The TLC level on POD 7 and 14 were significantly higher in EEN group than that in TPN group （t=5.645,5.134,all P〈0.05）.The PG-SGA score was lower in EEN group than that in TPN group,particularly on POD 21（t=5.211,P〈0.05）. Conclusion Total gastreetomy for gastric cancer after curative resection of early enteral nutrition support can improve the postoperative intestinal function recovery and shorten the time of hospital stay for patients.
出处
《中国基层医药》
CAS
2013年第1期29-31,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
肠道营养
胃肠外营养
胃切除术
胃肿瘤
Enteral nutrition
Parenteral nutrition
Gastrectomy
Stomach neoplasms
