早期肠内营养对胃癌术后患者营养状况和肠功能的影响

Effect of early enteral nutrition on nutritional status and bowel function of gastric cancer surgical patients

目的:探讨胃癌病人术后早期肠内营养对机体营养状况和肠功能的影响。方法:选择胃癌根治性手术病人60例,随机分为两组:早期肠内营养组30例,于术后24 h应用瑞素进行早期肠内营养,共实施7 d;肠外营养组30例,术后给予全肠外营养治疗。两组病人分别于手术前1 d、术后第1、8天检测营养指标血清清蛋白(ALB)、转铁蛋白(TF)和前清蛋白(PA),并观察肠功能恢复时间。结果:术后第1天两组患者血清清蛋白、转铁蛋白和前清蛋白浓度较术前有明显下降(P<0.05或0.01),经过一段时期的肠内营养和肠外营养支持后基本恢复到术前水平,肠内营养的营养恢复作用与肠外营养相比无明显差异。肛门排气/排便时间两组病人差异显著(P<0.01)。两组病人在观察期间均未发生严重并发症。结论:术后早期肠内营养支持可以改善胃癌病人的营养状况,促进肠蠕动恢复的作用优于肠外营养。

Objectives： To investigate nutritional status and bowel function effect of early enteral nutrition （EEN） in surgical patients with gastric cancer. Methods： Sixty postoperative patients with gastric cancer were randomly divided into EEN group and parental nutrition （PN） group. The patients in EEN group re- ceived RUISU early enteral nutrition from postoperative day 1 to postoperative day 7. The patients in PN group received total parental nutrition. ALB, PA, TF were detected on the day before the operation and the postoperative days 1 and 8 . And the restoring time of intestinal movement was observed. Results： On the 1 day postoperatively, ALB, TF , PA in two groups decreased significantly （P〈 0.05, P 〈 0.05, P 〈0.01）. On the 8th day, there were no significant differentce in ALB, PA, PF in EN-group than in PN- group （P 〉0.05）. The restoring time of bowel movement was significantly decreased in the EN group compared with PN group after operation （P〈0.01）. In both EEN group and PN group there were no serious complications. In both EEN group and PN group there were no serious complications. Conclusions： Early enteral nutrition can improve nutritional status, and compared with the parental nutrition, early enteral nutrition can promote the recovery of bowel function in gastric cancer surgical patients.