早期肠内营养对全胃切除胃癌患者早期预后的影响

Effect of early enteral nutrition on patients' early prognosis after total gastrectomy for gastric cancer

目的探讨早期肠内营养对全胃切除胃癌患者早期预后的影响。方法 70例全胃切除患者随机分为早期肠内营养(EEN)组和肠内、肠外联合营养(EN+PN)组各35例。比较2组术后早期恢复情况及实验室指标:血红蛋白(HB)、血白蛋白(ALB)、血前白蛋白(PA)、血淋巴细胞数(LYM)及血淋巴细胞百分比(LYM%),丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、血尿素氮(BUN)、血肌酐(Cr)。结果营养治疗后(术后第8天)EEN组各指标改善情况优于EN+PN组,差异有统计学意义(P<0.05和P<0.01)。与(EN+PN)组相比,EEN组的肛门排气时间明显缩短,术后住院天数明显缩短,住院费用明显减少,差异均有统计学意义(P<0.01)。2组并发症发生率比较差异无统计学意义(P>0.05)。结论全胃切除术后早期肠内营养是可行的,其可改善患者的营养状况及免疫功能,减少对肝、肾功能的影响,促进肠道功能的快速恢复,缩短住院天数,降低住院费用。

Objective To determine the effect of early enteral nutrition on early prognosis of patients underwent curative total gastrectomy for gastric cancer. Methods 70 cases of total gastrectomy were randomly divided into early enteral nutrition （EEN） group and intestinal combined parenteral nutrition （EN ＋ PN） group, with 35 cases in each. Early postoperative recovery and laboratory parameters in the two groups were compared：hemoglobin （HB）, albumin （ALB）, serum prealbumin （PA）, blood lymphocyte count （LYM） and the percentage of blood lymphocytes （LYM%）, alanine aminotransferase （ALT）, aspartate aminotransferase （ AST）, blood urea nitrogen （BUN） and creatinine （Cr）. Results Compared with EN ＋ PN group, patients in EEN group had better indicators, and the differences were statistically significant （P 〈 0.05 and P 〈 0.01 ） ;Com- pared with （EN ＋ PN） group, flatus time in EEN group was significantly shorter,postoperative hospital stay was significantly shorter and hospitalization costs were significantly reduced, and the differences were statistically significant （P 〈0.01 ）. There were no significant differences in the incidence of complications between 2 groups（ P 〉 0.05）. Conclusion Early enteral nutrition ＇after curative total gastrectomy for gastric cancer is feasible,which could lead improvement to nutritional status and immune function, reduce damage to liver and kidney, could result in faster recovery of bowel function, a shorter hospitalization and low hospital costs.