胃癌术后早期肠内外营养治疗对前白蛋白和高敏C反应蛋白的影响

Effect of early enteral nutrition on pre-albumin and high-nsitivity C-reactive protein in patients with gastric cancer after operation

目的观察早期肠内营养(EEN)和肠外营养(PN)对胃癌术后患者的前白蛋白(PA)和高敏C反应蛋白(hs-CRP)的影响。方法选取胃癌术后患者68例,随机分为EEN组和PN组各34例。观察2组体质量(BW)、血清白蛋白(ALB)、转铁蛋白(TF)、PA和hs-CRP、住院时间、术后营养支持费用和并发症发生率的差异。结果 2组术后7 d的BW、TF、ALB和PA均较术前1 d出现明显的降低(P均<0.01),而PN组的TF和PA水平较EEN组降低更为明显(P均<0.01),2组的BW和ALB水平无显著性差异(P均>0.05)。2组hs-CRP均较术前1 d明显升高,而PN组升高较EEN组更为明显(P<0.01)。EEN组的肛门排气、住院时间和营养支持费用均较PN组明显缩短或者降低(P均<0.01)。2组并发症比较无显著性差异(P均>0.05)。结论 EEN有助于调节胃癌术后患者对手术的应激,促进机体恢复,加快机体的胃肠功能的恢复,且价格低廉,有助于推广。

Objective It is to observe the influence of early enteral nutrition（EEN） and parenteral nutrition（PN） on prealbumin（PA） and high-sensitivity C-reactive protein（hs-CRP） in patients with gastric cancer after operation.Methods 68 patients with gastric cancer after operation were randomly divided into EEN group and PN group,34 cases in each group.The body weight（BW）,serum albumin（ALB）,transferrin（TF）,PA and hs-CRP,duration of hospitalization,postoperative nutritional support costs and complication rate in both groups were observed and compared.Results In day 7 after operation,the levels of BW,TF,ALB and PA were significantly lower compared with pre-operation in both groups（all P0.01）,but the levels of TF and PA in PN group were more obvious significantly than those in EEN group（P0.01）,there were no significant difference in levels of BW and ALB between two groups（all P0.05）.The levels of hs-CRP was increased significantly compared with pre-operation in both groups（all P0.01）,but the levels of hs-CRP in PN group was increased more obviously than those in EEN group（P0.01）.The length of stay and cost of nutritional support in EEN group were significantly shorter or lower compared with PN group（all P0.01）,while the rates of complication were no significant difference between both groups（P0.05）.Conclusion EEN can help to regulate the stress of operation in patients with gastric cancer,promote the recovery of the body and gastrointestinal function,and it can help to spread because of low-costs.