胃癌根治术后早期肠内营养对临床结果影响

Observation of early oral eternal nutrition on clinical outcomes after gastric cancer surgery

目的 观察胃癌根治术后早期肠内营养对胃癌根治术临床结局的影响.方法 我院2010年1月~2012年9月收治50例胃癌患者并行根治术,依据随机对照原则将50例患者分为观察组（25例）与对照组（25例）.观察组术后给予早期多次少量饮水、进食肠内营养制剂,对照组术后采用传统围手术期处理方案.观察并比较两组患者的临床结局、术后营养情况及免疫功能.结果 观察组术后发热持续时间、术后肛门排气时间、术后住院时间、体重消耗值及治疗费用明显低于对照组,其差异有统计学意义（P〈0.05）;术后第3天及第7天,观察组的清蛋白、前清蛋白、CD3＋、CD4＋、NK细胞、CD4/CD8水平高于对照组,其差异有统计学意义（P〈0.05）;CD8水平低于对照组,其差异有统计学意义（P﹤0.05）;两组术后并发症发生率的差异无统计学意义（P〉0.05）.结论 胃癌根治术患者术后早期进食肠内营养制剂能改善患者的临床结局,恢复肠道功能,同时提升患者的营养状况及免疫功能,值得临床推广应用.

Objective To investigate the effect of early oral feeding with eternal nutrition preparation after surgery on clinical outcomes in patients with gastric cancer. Methods From January 2010 to September 2010, a total of 50 patients with gas- tric eancer after radical gastric carcinoma resection in our hospital were randomly divided into 2 groups： the observation group （25 eases） and the eontrol group （n = 25）. All patients in the observation group were treated with administration of water and eternal nutrition early after surgery and the patients in the control group were treated with conventional postoperative care protocol. Clinical outcomes, nutritional status and immune function between the two groups were compared. Results The postoperative duration of fever, time of anal exhaust, duration of stay in hospital, value of weight consumption and the medical cost were markedly lower than those in the control group, there were significant difference （ P 〈 0.05 ）. The levels of albumin, prealbumin, CD3 ＋ , CD4 ＋ , NK cell, CD4 ＋/CD8 ＋ in the observation group on postoperative day 3 and 7 were higher than the control group, there were signif- icant difference（ P 〈 0.05） . The level of CD8＋ in the observation group was lower than the eontrol group, there was significant difference （ P 〈 0. 05 ） . There was no significant differenee in morbidity between the two groups （ P 〉 0.05 ）. Conclusion Early oral feeding with eternal nutrition preparation after surgery could improve the clinical outcomes, recovery the intestinal function and improve the nutritional status and immune function. This treatment was deserved to be used in elinical widely.