老年胃癌合并糖尿病患者术后早期肠内与肠外营养对比研究

Comparative Study of Postoperative Early Enteral Nutrition and Parenteral Nutrition in Elderly Patients with Type-2 Diabetes Undergoing Gastrectomy for Gastric Carcinoma

目的探讨老年胃癌合并糖尿病患者术后早期肠内营养的合理性和安全性。方法将60例老年胃癌合并糖尿病患者随机分为早期肠内营养组(EEN,30例)和肠外营养组(PN,30例)。检测手术前和手术后第4、10天营养指标和肝功能等变化,详细记录血糖变化,观察临床恢复情况。结果术后肠内营养组血糖水平波动较肠外营养组平稳(P<0.01)。术后第4天EEN组患者的各项营养指标和肝功能指标恢复明显高于PN组患者(P<0.01)。并发症发生率EEN组少于PN组,差异有统计学意义(P<0.01)。结论胃肠肿瘤手术后早期应用肠内营养对老年糖尿病患者是一个较好的方法,方便血糖调控,同时可促进机体康复,减少并发症。

Objective To evaluate the feasibility and safety of early enteral nutrition in elderly patients with type-2 diabetes undergoing gastrectomy for gastric carcinoma.Methods 60 elderly patients with diabetes undergoing gastrectomy were randomly divided into early enteral nutrition group（EEN group,n=30） and parenteral nutrition group（PN group,n=30）.Several blood chemistries and nutritional status were compared between the two groups on the preoperative days and the 4th and 10th postoperative days.The levels of blood glucose and clinical recovery were carefully monitored.Results The fluctuations of blood glucose in EEN group were significantly lower than the PN group in postoperative days（P0.01）.On the 4th postoperative day,nutritional markers and biochemical indicators in the EEN group were better than that in the PN group（P0.01）.It also decreases the rate of postoperative infections and other complications（P0.01）.Conclusion Postoperative early enteral nutrition for elderly patients with type-2 diabetes is a better method and more convenient to control blood glucose.It can also promote physical recovery and reduce the postoperative complications.