老年胃癌根治术后肠外与肠内营养支持的疗效对比

Comparative efficacy in advanced gastric cancer after postoperative parenteral and enteral nutrition support

目的比较老年胃癌根治术后肠外与肠内营养支持的疗效。方法回顾性分析2010年1月至2013年1月接受胃癌根治术的老年患者的临床资料。依据患者术后营养支持方式的不同分为观察组(肠内营养支持)及对照组(肠外营养支持)。比较两组患者营养支持7 d后营养学指标、免疫学指标的变化;两组患者术后并发症、代谢紊乱并发症以及术后恢复情况。结果共纳入观察组30例,对照组30例。观察组术后7 d血甘油三酯、胆固醇、白蛋白及前白蛋白均显著高于对照组(P<0.05)。观察组术后7 d CD4/CD8、Ig A及Ig G均显著高于对照组(P<0.05)。观察组患者术后并发症发生率、代谢紊乱发生率显著低于对照组,差异具有统计学意义(P<0.05)。两组患者在术后恢复通气时间上比较差异无统计学意义(P>0.05)。观察组术后住院时间、拔除引流管时间和显著术后开始下床活动时间均明显短于对照组,差异具有统计学意义(P<0.05)。结论老年胃癌术后营养支持中,采用肠内营养可以加速患者术后恢复、更好地维持和改善营养状况,降低术后并发症及代谢紊乱的发生率。

Objective To compare the efficacy of advanced gastric cancer in elderly patients after postoperative parenteral and enteral nutrition support. Methods Retrospective analysis from 2010 January to 2013 January was performed in clinical data of gastric cancer patients undergoing radical operation in our hospital. On the basis of different nutritional support ways,patients were divided into observation group（enteral nutrition）and control group（parenteral nutrition）. Results There was a total of 30 cases in observation group,30 cases in the control group. The serum triglyceride,cholesterol,albumin and pre albumin of observation group 7 days after operation was significantly higher than that of the control group（ P 〈 0. 05）. The CD4 / CD8,IgA and IgG of observation group 7 days after operation were significantly higher than those in the control group（ P 〈 0. 05）. The incidence of postoperative complications and metabolic disorders in the observation group was significantly lower than that of the control group. The differences were statistically significant（ P 〈 0. 05）. The postoperative recovery ventilation between the two groups was not statistically significant（ P 〉 0. 05）. The postoperative hospital stay,time and significant removal tube drainage after starting ambulation in the observation group were significantly shorter than the control group（ P 〈 0. 05）. Conclusion Elderly gastric cancer postoperative nutritional support,enteral nutrition support can accelerate postoperative recovery,better maintain and improve the nutritional status,reduce the postoperative complications and the incidence of metabolic disorders.