早期肠内营养对胃癌患者术后并发症的影响

Effects of early enteral nutrition on post operative complications in patients with gastric cancer

目的:观察术后早期肠内营养支持对胃癌患者手术后并发症的影响。方法:107例胃癌根治术后患者随机分为两组。观察组(59例):术后早期24 h经空肠营养管行肠内营养;对照组(48例):行静脉输液补充营养。观察两组患者术后首次肛门排气排便时间,术后住院日以及术后并发症发生率的差异。结果:早期肠内营养组与对照组相比,术后首次肛门排气时间[(52±18)h vs(81±35h)]、首次排便时间[(73±26)h vs(102±19)h]明显提前,术后住院时间[(9.7±4.1)d vs(13.2±6.4)d]明显缩短,两组比较差异显著(P<0.05)。观察组切口感染并发症(1/59,1.7%)显著低于对照组(7/48,14.6%)(P<0.05);观察组术后感染总发生率(6/59,10.2%)显著低于对照组(12/48,25%)(P<0.05);总体并发症比较,观察组(14/59,23.7%)稍低于对照组(13/48,27.1%),但无统计学差异(P>0.05)。结论:胃癌患者术后早期行肠内营养支持是安全有效的,可促进术后胃肠功能恢复,缩短住院时间;并不增加术后并发症发生率,同时可以显著减少感染并发症的发生。

Objective：To observe the effects of early enteral nutritional support on postoperative complications in patients with gastric cancer . Methods：107 cases undergone radical resection of gastric cancer were randomized into experimental group （ Enteral nutrition via jejunal feeding tube in 24 h following the procedure,n=59） and control group（ Conven-tional intravenous nutrition support,n =48）.The two groups were com-pared pertinent to the time of first flatus and bowl movement ,the postoper-ative length of hospital stay and incidences of postoperative complications . Results： The time of first flatus [（52 ±18）h vs.（81 ±35）h] and bowel movement[（73 ±26）h vs.（102 ±19）h] and postoperative hospital stay [（9.7 ±4.1）d vs.（13.2 ±6.4）d）] were significantly shortened in the experimental group than those of the controls（P0.05）.Conclusion： Early enteral nutritional support seems safe and effective and may facilitate early recov-ery of the gastrointestinal function for patients following gastrectomy .In addition,this early intervention doesn′t result in increased risks of postop-erative complications,and differently leads to significantly reduced inci-dence of wound infection.