全肠外营养与肠外联合肠内营养对老年性胃癌根治术后早期的影响

Clinical significance of total parenteral nutrition and parenteral nutrition combined with enteral nutrition in the early stage of gastric cancer after radical operation

目的:探讨经不同的营养途径支持对老年胃癌术后患者的疗效分析。方法:选取皖南医学院弋矶山医院胃肠二科2014年03月至2015年11月收治的老年性胃癌患者(年龄>70岁)并行胃癌根治术手术患者60例。随机分为30例肠外联合肠内营养组(EPN)和全肠外营养组(TPN)30例。分别对比分析术后营养指标、肝功能指标、并发症和术后恢复情况。结果:EPN和TPN两组内患者术后总蛋白(TP)、总蛋白(ALB)、前白蛋白(PA)较术前比较差异均有统计学意义(P<0.05),EPN组术后TP、PA较TPN组比较差异有统计学意义(P<0.05)。两组内患者γ-谷氨酰转肽酶(GGT)差异有统计学意义(P<0.05),余肝功能指标差异无统计学意义(P>0.05),两组术后在并发症方面差异无统计学差异(P>0.05),EPN组在术后通气时间明显少于TPN组(P<0.05)。而术后住院天数,进流质时间与住院费用差异无统计学意义(P>0.05)。结论:EPN可以缩短胃肠道恢复时间,缩短住院时间,肠内营养结合肠外营养是一种更好的策略,为老年胃癌患者接受外科手术治疗提供了营养支持。

AIM： To investigate the effect of different nutritional support on elderly patients with gastric cancer after operation. METHODS： 60 cases of elderly patients with gastric cancer （ age 〉 70 years old） admitted to our hospital between March 2014 and November 2015 were selected and randomly divided into total parenteral nutrition（TPN） group （30 cases） and combined parenteral and enteral nutrition （EPN） group （ 30 cases）. Nutritional indexes, liver function indexes, complications and postoperative recovery were compared and analyzed respec- tively. RESULTS ：Significant difference were detected in nutritional parameters between the EPN gand TPN （P 〈 0.05 ）, the difference of GGT index of patients with liver function was statistically significant （ P 〈 0.05 ）, no significant difference between the residual liver function index （ P 〉 0.05 ） as well as the postoperative complications between the two groups （P 〉 0.05 ）. The ventilation time in the EPN group was detected significantly less than that in the TPN group （ P 〈 0.05 ） , whereas no significant difference was found regarding the postoperative hospital stay, liquid time and hospitalization expenses （ P 〉 0.05 ）. CONCLUSION ： EPN can shorten the recovery time of gastrointestinal tract and the hospitalization time. Parenteral nutrition combined with enteral nutrition is a better strategy to provide nutritional support for elderly patients with gastric cancer undergoing surgical treatment.