术后早期肠内营养在胃癌病人治疗中的临床观察

Early enteral nutrition in postoperative patients of gastric cancer

目的:运用快速康复理论,通过比较早期肠内营养(EEN)和常规肠内营养(EN)组间围手术期病人营养状况、炎症指标、免疫水平及临床指标,观察EEN对胃癌病人术后恢复的影响。方法:前瞻性分析65例胃癌术后病人,按照不同时间EN支持分为EEN组(n=33)和EN组(n=32)。比较两组病人术前1天、术后第3天和术后第7天的血清总蛋白、血清白蛋白、前白蛋白、白细胞总数、C反应蛋白以及T淋巴细胞亚群、免疫球蛋白(Ig G),同时观察病人早期胃肠道恢复时间、住院天数及平均住院费用等指标。结果:EEN组病人术后第7天营养指标和细胞免疫指标大多高于EN组,EEN组病人术后第3天炎症指标低于EN组,两组间有显著差异(P<0.05)。EEN组在术后短期内免疫水平和临床恢复及住院时间方面都优于EN组(P<0.05)。结论:胃癌术后早期肠内营养支持,对早期提高术后病人营养状况、免疫功能及减轻炎症反应具有显著作用,促进了胃肠功能的恢复,缩短了住院时间。

Objective： To investigate the effects of early postoperative enteral nutrition on recovery of patients with gastric cancer. Methods： Sixty-five cases of patients with gastric cancer were randomized into early enteral nutrition（EEN） group and enteral nutrition（EN） group. Serum total protein（TB）,albumin（ALB）,Prealbumin,white blood cell count（WBC）, C-reactive protein（CRP）,immunoglobulin,peripheral T-lymphocyte subsets,gastrointestinal recovery time, hospital stay and cost were recorded. The nutritional and cellular immunity parameters of the EEN group on 7th day after operation were higher than those of the EN group.Inflammatory response of the EEN group on 3th day after operation was lower than EN group. EEN group showed better immunological response and clinical recovery than the EN group（P〈0.05）. Conclusion： Early enteral nutrition in postoperative gastric cancer patients can improve early postoperative nutritional status and immune function,alleviate inflammatory response,promote the recovery of intestinal function and shorten hospital stay.