肠外结合肠内营养支持对胃癌切除术后并发吻合口瘘患者的影响

Effects of parenteral and enteral nutrition support on patients with anastomosis fistula after resection of gastric cancer

目的 探讨肠内外营养支持对胃癌切除术后并发吻合口瘘患者的影响.方法 以安阳市人民医院2011年4月至2013年12月收治的50例胃癌切除术后并发吻合口瘘患者为研究对象,随机将其分为两组,每组25例,对照组给予肠外营养支持,实验组行肠内外结合营养支持,对两组干预前后营养指标、住院时间及并发症等情况进行比较.结果 实验组肛门排气时间、住院时间分别为（3.02±0.58）d、（30.24±6.35）d,明显短于对照组的（4.95±0.80）d、（30.24±6.35）d,差异有统计学意义（P＜0.01）.同时两组治疗后前白蛋白[（296.59±50.25） mg/L vs（240.17±40.10） mg/L]、转铁蛋白[（2.88±0.36） mg/L vs （2.00±0.14） mg/L]、血清白蛋白[（36.13±3.49） g/L vs（33.08±4.20） g/L]水平比较差异有统计学意义（P＜0.05）.另外两组并发症发生率比较差异未见统计学意义（P＞0.05）.结论 肠内外结合营养支持治疗能明显改善患者的营养状况,减少相关并发症,缩短住院时间.

Objective To investigate the effect of parenteral and enteral nutrition support on patients with anastomosis fistula after resection of gastric cancer.Methods From April 2011 to December 2013,50 patients with anastomosis fistula after resection of gastric cancer in our hospital were selected as research objects,and were randomly divided into two groups with 25 cases in each group.The patients in control group were treated with parenteral nutrition support,and the patients in experiment group underwent enteral combined with nutritional support.Before and after intervention,the nutrition index,hospital stay and complications were compared.Results In the experiment group,the anal exhaust time,hospitalization time was （3.02 ± 0.58） d,（30.24 ± 6.35） d,which were significantly shorter than those of the control group [（4.95 ±0.80） d,（30.24 ±6.35） d] （P〈0.01）.At the same time,after treatment,the serum prealbumin[（296.59 ± 50.25）mg/L vs（240.17 ±40.10） mg/L],transferrin [（2.88 ± 0.36） mg/L vs（2.00 ± 0.14） mg/L],serum albumin[（36.13 ±3.49）g/L vs（33.08 ±4.20）g/L] level differences were significant （P 〈 0.05）.In the other two groups,the incidence of complications had no significant difference （P 〉 0.05）.Conclusions Eenteral and parenteral nutrition support treatment can obviously improve the nutritional status,reduce complications,and shorten hospitalization time.