肠内营养与肠外营养在腹腔镜胃肠道肿瘤患者术后早期应用的临床研究

Clinical effect of enteral immunonutrition united parenteral nutrition on early period of laparoscopic postoperative in gastrointesinal tumor patients

目的分析腹腔镜下胃肠道肿瘤术后患者早期联合应用肠内营养与肠外营养的临床效果。方法经腹腔镜行胃肠道肿瘤根治术患者50例，将50例患者随机分为实验组及对照组。对照组患者术后24小时给予肠外营养（卡文，1440ml），实验组患者在肠外营养基础上联合应用肠内营养（瑞能，400ml）。比较两组患者术前、术后生化指标（血清白蛋白、血红蛋白、总蛋白），免疫指标（IgA、IgG），炎症指标[C反应蛋白（CRP）、C3]及术后并发症发生率。结果术后第7天，两组患者生化指标较术前均有明显改善，组内比较差异有统计学意义（P〈0．05）。两组间比较差异无统计学意义（P〉0．05）。实验组C3、IgA、IgG均高于对照组，CRP低于对照组，差异有统计学意义（P〈0．05）。实验组术后并发症发生率低于对照组，差异有统计学意义（P〈0．05）。结论腹腔镜下胃肠道肿瘤患者术后早期联合应用肠内营养与肠外营养能有效减少术后并发症的发生，改善炎症指标，促进胃肠道功能及免疫功能恢复，改善术后营养状况。

Objective To evaluate the effect of immune enteral nutrition combined with parenteral nutrition in early laparoscopic postoperative gastrointestinal cancer patients. Methods Totally 50 gastrointestinal cancer patients under laparoscopic surgery were selected, and randomly divided into experimental group and control group. The control group received parenteral nutrition （Kabiven TM PI, 1440 ml） , while the experimental group received enteral nutrition based on the treatment of control group. The levels of biochemical indices （ ALB, TP, HGB ）, immunological indices （ IgA, IgG ）, inflammatory indices （ CRP, C3 ） and the incidence of postoperative complications were checked. Results The biochemical indices of the two groups patients were significantly improved compared with preoperative, the difference was statistically significant（ P 〈 0.05 ）. Between the two groups, the difference was not statistically significant （P 〉 0.05 ）. C3, IgA and IgG level in experimental group were higher, while CRP level lower than the control group, the difference were statistically significant （ P 〈 0.05 ） ; postoperative complications in the experimental group was lower than the control group, the difference was statistically significant （P 〈 0.05）. Conclusion Laparoscopic gastrointestinal cancer patients early combined enteral nutrition with parenteral nutrition can effectively reduce the incidence of postoperative complications, reduce inflammatory. markers, promote recovery of gastrointestinal function and improve the nutritional status.