全胃切除术后肠外结合肠内营养支持

The support effects of PN with EN after total gastrectomy

目的：对比全胃切除术后的肠外营养（ＰＮ）结合肠内营养（ＥＮ）与标准ＰＮ的支持效果。方法：１６例患者随机分为两组，两组患者从术后ｄ１到术后ｄ１１进行等氮、等热量营养支持。结果：（１）ＰＮ＋ＥＮ组体重下降（１．２±０．２２）ｋｇ，ＰＮ组体重下降（２．６１±０．１６）ｋｇ；（２）ＰＮ＋ＥＮ组１１ｄ累积氮平衡（２２３．３±３２．９）ｍｇ／ｋｇ，ＰＮ组１１ｄ累积氮平衡（１３４．６±１８．５）ｍｇ／ｋｇ；（３）ＰＮ＋ＥＮ组血清白蛋白下降（０．６±０．２）ｇ／Ｌ，ＰＮ组下降（６．０＋０．３）ｇ／Ｌ；（４）ＰＮ＋ＥＮ组德中谷氨酰胺下降（１８±６．４）μｍｏｌ／Ｌ，ＰＮ组下降（１０７±７．８）μｍｏｌ／Ｌ；（５）ＰＮ＋ＥＮ组血中Ｃ３补体下降（１１±３２）ｍｇ／Ｌ，ＰＮ组下降（１０２±６２）ｍｇ／Ｌ。结论：ＰＮ结合ＥＮ较标准ＰＮ更适合于全胃切除术后的肠功能恢复特点。

Objective:To evaluate the support effects of PN (parenteral nutrition) with EN (enteral nutrition) and PN on a trial of 16 patients with total gastrectomy.Methods:All subjects were randomly divided into 2 groups of PN+EN and PN, and received iso nitrogenous, iso caloric nutritional support form POD(Post Operation Day) 1 to POD 11. Results:The weight losts was (1.2±0.22)kg in PN+EN patients where as 2.6±0.16 kg in PN group. Also PN+EN patients was superior to PN patients in cumulative nitrogen; and the following parameters were also significantly different between PN+EN and PN, as serum albumin loss was (0.6±0.2)g/L vs(6.0±0.3)g/L;serum glutamine loss was (18±6.4)μmol/L vs (107±7.8)μmol/L and serum C 3 loss was (11±32) mg/L vs(102±62)mg/L respectively ( P <0.05￣0.01) Conclusion:Our data indicate that PN+EN is more efficient in total gastrectomy than PN.