摘要
目的探讨在胃癌患者远端胃大部切除联合Roux-en-Y吻合术后营养支持治疗的方法,并分析其临床作用。方法回顾性分析侯马市人民医院2016年9月至2018年5月收治的实施远端胃大部分切除联合Roux-en-Y吻合术治疗的79例胃癌患者的临床资料,根据营养支持治疗方式分为肠内组(42例,接受肠内营养支持)与肠外组(37例,接受肠外营养支持)。比较两组术后恢复时间,术后当天和术后7d机体营养指标、体液免疫指标变化,术后并发症发生率。结果肠内组术后首次排气、首次排便、首次下床活动时间和住院时间均短于肠外组(P均<0.05)。术后7d,肠内组血红蛋白(HGB)、血清前白蛋白(PAB)、血浆白蛋白(ALB)、总蛋白(TP)、免疫球蛋白(IgA、IgG、IgM)、补体3(C3)、补体4(C4)水平均升高(P均<0.05),肠外组基本无变化(P>0.05);且术后7d肠内组上述指标均高于肠外组(P<0.05)。术后7d,肠内组内总并发症发生率低于肠外组(P均<0.05)。结论对于胃癌患者,远端胃大部分切除联合Roux-en-Y吻合术后给予肠内营养支持较肠外营养支持者能够加快患者恢复,改善机体营养指标和体液免疫指标,降低并发症发生率。
Objective To investigate the method of nutritional support after distal subtotal gastrectomy combined with Roux-en-Y anastomosis in patients with gastric cancer and analyze its clinical effect.Methods The data of 79 patients with gastric cancer treated by distal subtotal gastrectomy combined with Roux-en-Y anastomosis from September 2016 to May 2018 in Houma People’s Hospital were retrospectively analyzed.According to the nutritional support methods,patients were divided into enteral group(42 cases,receiving enteral nutritional support)and parenteral group(37 cases,receiving parenteral nutritional support).The postoperative recovery time,the changes of body nutrition indexes,humoral immunity indexes and the incidences of postoperative complications were compared between the two groups.Results The first exhaust,first defecation,first ambulation and hospitalization time in enteral group were shorter than those in parenteral group(P<0.05).The levels of hemoglobin(HGB),serum prealbumin(PAB),plasma albumin(ALB),total protein(TP),immunoglobulin(IgA,IgG,IgM),complement 3(C3),complement 4(C4)were increased in enteral group 7 days after operation(P<0.05),which were unchanged in parenteral group(P>0.05);and the levels of the above indexes in enteral group were higher than those in parenteral group 7 days after operation(P<0.05).The total incidence of postoperative complications in enteral group was significantly lower than that in parenteral group 7 days after treatment(P<0.05).Conclusions Compared with parenteral nutrition support,enteral nutrition support after distal gastrectomy combined with Roux-en-Y anastomosis can quicken recovery,improve nutritional and humoral immune indexes,and reduce the incidence of complications in patients with gastric cancer.
作者
白璃
Bai Li(Department of General Surgery,Houma People’s Hospital,Houma 043000,China)
出处
《中国实用医刊》
2019年第9期79-82,共4页
Chinese Journal of Practical Medicine
