胃癌术后早期肠内营养的临床应用分析

Application of the early postoperative enteral nutrition in patients with gastric cancer

目的探讨胃癌患者术后早期肠内营养的临床效果。方法对我院2009年1月至2010年12月收治的60例胃癌患者随机分为研究组与对照组。研究组于术后24h后开始逐渐肠内营养至125．52kJ／（kg·d），共实施7d。对照组给予常规输液治疗，肠功能恢复后逐渐进普通流质饮食。两纽患者于术前及术后第8天测体质量（Bw）、肱三头肌皮皱厚度（TSF）、上臂肌围（AC）、白蛋白（TP）、清蛋白（Alb）、转铁蛋白（TRF）、淋巴细胞总数及胃肠功能恢复时间。结果两组患者淋巴细胞总数、TP、Alb、TRF较术前均有所下降，两组比较差异有统计学意义（P〈0．05）。研究组与对照组治疗前后BW、TSF、AC差异有统计学意义（P〈0．05）。研究组患者胃肠功能恢复较对照组明显缩短（P〈0．01）。结论胃癌术后早期肠内营养有利于胃肠功能恢复，改善营养，提高外周淋巴细胞总数，增强免疫功能，减少并发症，提高手术成功率。

Objective To investigate the effect of early postoperative nutrition on patients with gastric cancer after operations. Methods Sixty gastric cancer patients from Jan. 2009 to Dec. 2010 were randomly devided into study group （EEN group） and control group. Patients in EEN group were submitted to early enteral nutrition support of 125.52 kJ/（kg · d） from the second postoperative day to the eighth postoperative day. Patients in control group were submitted to normal liquid diet gradually after recovery of intestinal function. The BW, AC, TSF, Alb, TRF and lymphocyte count were detected before surgery and on the eighth postoperative day. The recovering time of enterocinesia were observed. Results The losses of BW, TP, Alb and TRF were detected in the two groups（ P 〈 0.05 ）. Lymphocyte count after treatment in EEN group was significantly different （ P 〈 0.05 ） from that in control group. Compared to control group, the changes in EEN group was significantly different （P 〈 0.01 ）. The recovering time of enterocinesia was significantly decreased in the EEN group, compared with control group after operation（ P 〈 0.01 ）. Conclusions EEN can improve nutrition and immune function and promote the recovery of enterocinesia in patients with gastric cancer after surgery.