老年胃肠道肿瘤患者围手术期肠内营养的临床研究

Clinical study of perioperative enteral nutrition in elderly gastrointestinal neoplasm patients

目的探讨围手术期肠内营养对老年胃肠道肿瘤患者的影响。方法 60例老年胃肠道肿瘤患者随机分为实验组和对照组,观察术前5天及术后1、8天营养、免疫、炎性指标,术后并发症、术后住院时间、肛门排气/排便时间。结果实验组术后营养、免疫及炎性指标大多较对照组差异有统计学意义(P<0.05);术后并发症总发生率、感染性及非感染性并发症发生率、术后平均住院时间、排气/排便时间均较对照组差异有统计学意义(P<0.05)。结论围手术期肠内营养,对老年胃肠道肿瘤患者能改善营养状况、提高免疫水平、减轻炎性反应、降低并发症发生率、缩短术后住院时间、促进胃肠道功能恢复。

Objective To discuss the influences such as the nutritious situation,the immune function,the acute inflammatory responses,postoperative complications,the postoperative hospital stay and the recovery of gastrointestinal function when elderly gastrointestinal cancer patients are perioperatively administrated enteral immunonutrition. Methods Sixty elderly gastrointestinal cancer patients were randomly divided into enteral immunonutrition group and control group. The observation period was 5 days preoperative to 8 days postoperative. During this period of time,the two groups of patients were administrated enteral immunonutritious preparation and routine conventional treatment separately. All variables of nutrition,cellular and humoral immune,acute inflammatory response were measured on the fifth day preoperative and the first and eighth day postoperative,and made statistics of postoperative complications,the postoperative hospital stay and the defecation and anal exhaust time. Results The variables of nutrition,cellular and humoral immune and acute inflammatory response of the enteral immunonutrition group obviously increased than those of the control group,and most differences were significant（ P 0. 05） . The total incidence of postoperative complications,the incidence of infective complication and the incidence of noninfective complication of the enteral immunonutrition group was lower than those of the control group,and the differences were significant（ P 0. 05） . Though the incidence of more than two complications and the mortality was lower than those of the control group,the differences were not obvious（ P 0. 05） . The average postoperative hospital stay and the defecation and anal exhaust time of the enteral immunonutrition group was obviously shortened,and the differences were significant（ P 0. 05） . Conclusion The perioperative enteral nutrition support can significantly improve the nutrition status and the function of immune system,alleviate the inflammatory response,lower the incidence of postoperative complication,shorten postoperative hospital stay and prompt the recovery of gastrointestinal function.