胃癌根治术后早期肠内外营养的临床疗效观察

Efficacyof Early Postoperative Parenteral and Intra-intestinal Nutritional Support for Patients Undergoing Radical Sungery of Gastric Cancer

目的探讨胃癌患者行胃癌根治术后早期肠内、肠外营养支持的临床疗效。方法回顾性分析我院2003年10月～2011年1月收治的152例胃癌手术患者的临床资料,全部患者随机分为肠内营养组(EN)54例、肠外营养组(PN)52例和常规给液组46例。分析治疗后患者肛门排气时间、住院时间及不良反应情况,血清白蛋白(ALB)、前白蛋白(PA)和淋巴细胞总数(TLC)的临床指标。结果 EN与PN两组与常规给液组比较均能显著提高营养状况及免疫力、PA及TLC指标,与常规给液组和术前数据相比较均有统计学意义(P<0.05)。EN与PN两组与常规给液组比较,肛门排气时间提前,肺部感染减少,切口感染和咽部不适均减少(P<0.05)。结论胃癌患者术后早期行肠内、外营养支持可以改善营养状态,提高机体免疫水平,对胃癌患者术后早期恢复有重要意义。

Objective To explore the parenteral and intra-intestinal nutritional support for patients undergoing radical operation for carcinoma of stomach. Methods We retrospectively analyzed 152 pattens with stomach carcinoma from October 2003 to January 2011. The 152 cases were randomly divided into 3 groups, with 54 cases in the intra-intestinal nutrition group,52 case in parenteral nutrition group and 49 cases in common group. The values of ALB, PA, TLC, the time in hospital and exhaust and the occurrence of complications was recorded. Results There were significant differences on nutriture status and immunity, PA, TLC among EN, PN and common groups （ P 〈 0.05 ） and reduced the rate of infection of incisional wound, anus exhaust time pharyngopathy and pulmonary infection （P 〈 0.05 ）. Conclusion The application of the the parenteral and intra-intestinal nutritional support is very important for patients with stomach carcinoma to improve nutritional status, anus exhaust time, promote agglutination and reduce complications. Nutritional assessment and nutritional support is vital to reduce perioperative complications for patients with stomach carcinoma.