延期留置空肠穿刺造口管肠内营养在老年胃癌患者术后营养状态恢复中的应用

Application of Prolonged Enteral Nutritional Support by Needle Catheter Jejunostomy Feeding Tube for Old Postoperative Patients with Gastric Cancer

目的探讨延期留置空肠穿刺造口管肠内营养在老年胃癌患者术后营养状态恢复中的应用。方法56例老年胃癌根治术患者随机分为2组:A组和B组,每组28例。2组患者均在术后经空肠穿刺造口管行早期肠内营养支持治疗。B组术后行早期肠内营养支持治疗至出院时结束,A组术后行早期肠内营养支持治疗至出院后2周。观察2组患者营养状况的恢复及并发症的发生情况。结果A组出院前白细胞计数(WBC)、血红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TRF)水平与B组比较差异均无统计学意义(P均>0.05)。A组出院后WBC、Hb、Alb、PA、TRF水平与B组比较差异均有统计学意义(P均<0.05)。A组体质量与B组比较差异无统计学意义(P>0.05)。A组导管堵塞5例(17.9%),导管脱落1例(3.6%),腹壁局部软组织感染1例(3.6%);B组无并发症发生。结论延期留置空肠穿刺造口管肠内营养可以促进老年胃癌患者术后营养状态的恢复。

Objective To evaluate the effects of prolonged enteral nutrition by needle catheter jejunostomy （NCJ） tube on the nutrition status and recovery in old postoperative patients with gastric cancer. Methods Fifty-six old patients with gastric cancer undergoing radical gastrectomy were randomly divided into group A（n=28） and group B（n=28）. Jejunal feeding tube was placed during operation and early enteral nutrition（EN） was supplied in all cases. In the group B, jejunal feeding tube was removed before discharge, while the jejunal feeding tube was kept until the two weeks of discharge in group A. The nutritional status and complications were observed in two groups. Results Before discharge, no significant difference A group compared with B group in the level of WBC,Hb,Alb,PA,TRF（P〉0.05）. In the changes of Hb,Alb,PA,TRF,WBC, the group B was significantly less than that group A after prolonged EN （P〈（0. 05） ,but no significantly changes in body weight （P〉0.05）. In group A, there are 5 cases（17.90%） catheter obstruction, 1 case（3.6%） fall of the catheter, 1 case（3.6%） soft tissue infection in abdominal wall, but no severe complications were found in group B. Conclusion Prolonged EN support could improve nutritional status in postoperative old patients with gastric cancer.