老年胃癌患者术后早期肠内营养的应用价值分析

Application value of early enteral nutrition for elder patients after gastric cancer surgery

目的探讨早期肠内营养(EEN)支持治疗在老年胃癌患者术后的应用价值。方法选取60例老年胃癌术后行EEN支持的患者作为EEN组,同期老年胃癌术后行全肠外营养(TPN)的患者40例为TPN组。比较2组患者肛门排气时间、口服进食时间、消化道症状发生率、并发症发生率、住院时间、血清蛋白、免疫球蛋白、电解质等变化情况。结果 EEN组出现肛门排气时间较TPN组显著缩短(P<0.01);EEN组消化道症状出现率高于TPN组,经对症处理后消失;EEN组术后较术前体质量下降(1.8±0.2)kg,该下降值显著低于TPN组的(2.6±0.4)kg;EEN组住院时间较TPN组也明显缩短(P<0.05)。EEN组术后总蛋白、白蛋白及免疫球蛋白IgA显著高于TPN组(P<0.01)。EEN组电解质紊乱发生率显著低于TPN组(P<0.05)。结论 EEN营养支持适用于老年胃癌切除术患者,有助于改善患者的胃肠动力,缩短住院时间,维持机体免疫功能,有助于患者恢复。但容易出现胃肠道症状,需要控制输注速度和输入量。

Objective To explore the value of early enteral nutrition （EEN） for elder patients after gastric cancer surgery. Methods The 60 elder patients who accepted EEN after gastric cancer surgery were regarded as the EEN group, and 40 elder patients accepted total parenteral nutrition （TPN） were regarded as TPN group. The changes of anus exhaust time, oral feeding time, the incidence rate of digestive tract symptom, complications,length of hospital stay, serum protein,immunoglobulin, and electrolyte of the two groups were analyzed. Results The time of anusexhaust in EEN group was obviously shorten than that of TPN group （ P 〈 0.01 ） . The incidence rate of digestive tract symptom in EEN group was obviously higher than TPN group, but the symptoms were diminished after treatment. The decreasing degree of body weight in EEN group was （ 1.8 ± 0.2） kg which was significantly less than （ 2.6 ± 0.4） kg in TPN group. The length of stay in EEN group was shorten than TPN group （ P 〈 0.05 ）. The levels of total protein, albumin, and immunoglobulin A in EEN group was higher than TPN group （ P 〈 0.01 ）. The incidence rate of electrolyte disturbances in EEN group was obviously lower than TPN group （ P 〈 0.05 ）. Conclusion EEN is helpful to improve gastrointestinal motivation, shorten the length of hospital stay, maintain immune function and improve recovery. However,EEN is easy to cause digestive tract symptom,and it is necessary to control the input speed and volumes.