老年人胃癌术后早期肠内营养支持的临床研究

Clinical study of early postoperative enteral nutritional support in the aged patients with carcinoma of stomach

目的:研究老年人胃癌术后早期肠内营养支持的安全性和合理性。方法:选择年龄60岁以上胃癌手术的26例病人,随机分为肠内营养(EN)组和肠外营养(PN)组,每组13例。检测手术前后人体测量学指标及血红蛋白(Hb)、血浆清蛋白(ALB)、转铁蛋白(TFN)和纤维连接蛋白(Fn),同时观察胃肠功能恢复情况。两组营养支持均为等热量。结果:术后两组病人的人体测量学指标和Hb、ALB差异均无显著性意义(P>0.05);术后第8 d病人均由负氮平衡转为正氮平衡;术后第4、8 d时,两组的Fn比术前明显升高(P<0.05、P<0.01),而且术后第8 d时EN组的上升比PN组更明显(P<0.05);肛门排气时间EN组比PN组早(P<0.05)。结论:老年人胃癌术后给予早期肠内营养支持,可促进病人胃肠功能的恢复和改善营养代谢。

Objective：To study security and rationality of early postoperative enteral nutritional support in the aged patients with carcinoma of stomach. Methods：26 patients ≥sixty years old, after operation for carcinoma of stomach were selected and divided randomly into enteral nutrition （EN） group and parenteral nutrition （PN） group. Anthropometry index, hemoglobin （Hb） , plasma albumin （ALB） and transferrin（TFN） were detected before and after operation. The gastrointestinal function recovery state was observed simultaneously. Results：There were no significant differences in anthropometry, Hb and ALB during the two groups. All patients changed from negative nitrogen balance into positive nitrogen balance after 8 day＇s nutritional support. Fn was significantly higher on the postoperative 4 th and 8 th day than that before operation and was signifi cantly higher in EN group than that in PN group on the 8 th postoperative day. Recovery time of intestinal function was obviously earlier in EN group than that in PN group.