早期肠内营养支持在全胃切除术后患者中的应用

The application of supporting of early enteral nutrition among those patients suffering from carcinoma of stomach during the time after total gastrectomy

目的探讨早期肠内营养在全胃切除术后患者中应用的可行性和治疗效果。方法将40例胃癌需作全胃切除术的病人随机分为肠内营养组(EN,20例)和肠外营养组(PN,20例)。于术后24小时给予等氮、等热量营养支持,观察两组病人术后肠鸣音恢复、肛门排气时间和并发症的发生情况、手术前后营养指标、平均住院日及平均住院费用的差异。结果两组病人术后营养支持前后的营养指标均有明显改善(P<0.05);EN组与PN组间血糖相比有明显差异(P<0.05);EN组术后肠道功能恢复时间(42.20±16.07h)较PN组术后肠道功能恢复时间(66.40±20.82h)要早(P<0.05);同时平均住院费用明显减少(P<0.05)。结论早期肠内营养支持应用于全胃切除术后患者是安全可行的方法,既能促进患者肠道功能尽早恢复,改善了病人术后营养状况,又节约了医疗费用。

Objective To probe into the feasibility and therapeutic effect of supporting of early enteral nutrition among those patients suffering from carcinoma of stomach during the time after total gastreetomy. Methods The 40 patients suffering from carcinoma of stomach during the time ＇after total gastrectomy were randomized into group enteral nutoition（ EN ,20 cases）and penteric nutrition（ PN,20 cases）. At postoperative 24 hours,those patients would be given the supporting of nutrition which concluded equal nitrogen and equal quantity of heat. To observe the two group patients＇ differences of recovering of bowel sound, the times of anal exsufflation, occun＇ing of complications, nutritive index preoperative and postoperative, average hospitalization days and average the price of medical treatment. Results There are statistical significances between group EN and PN in nutrition in- dex preoperative and postoperative（ P 〈 0.05 ） ;blood glucose （P 〈 0.05 ） ;the time of function of intestines to recover（ EN ：42.20 ± 16.07 h, PN ：66.40 ± 20.82 h ; P 〈 0.05 ） and average hospitalization cost （ P 〈 0.05 ）. Conclusion It＇s a safe and feasible method that supporting of early enteral nutrition among those patients suffering from carcinoma of stomach during the time after total gastrectomy. The supporting of early enteral nutrition not only could promote patients＇ function of intestines to recovering as quickly as possible, but also could improve patients＇ nutrition condition postoperative and reduce the price of medical treatment.