胃癌术后早期肠外联合肠内营养支持治疗的临床效果

Clinical effect of early postoperative enteral and parenteral nutrition support in patients with gastric cancer

目的探讨胃癌术后早期肠外联合肠内营养支持治疗的临床效果。方法选择我院行胃癌手术的145例患者,将其随机分为肠外营养组(PN组)48例、肠内营养组(EN组)47例和肠外营养联合肠内营养(联合组)50例,PN组给予肠外营养支持,EN组给予肠内营养支持,联合组患者给予肠外营养联合肠内营养支持,比较3组患者营养指标、细胞免疫变化情况以及营养支持临床效果。结果术后7d3组患者营养指标均显著升高(P<0.05),且联合组患者升高程度显著优于PN组和EN组(P<0.05);3组患者术后7dCD3^+、CD4^+以及CD4^+/CD8^+水平显著升高(P<0.05),而CD8^+水平明显降低(P<0.05),且联合组患者改善程度显著优于PN组和EN组(P<0.05);联合组患者肛门排气时间、术后住院时间以及感染发生率均显著低于PN组和EN组(P<0.05)。结论胃癌术后早期肠外联合肠内营养支持能够显著改善机体营养状态以及免疫功能,有助于患者肠道功能恢复时间、住院时间的缩短,同时能够显著降低患者术后感染发生率,可在临床推广运用。

Objective To investigate the clinical effect of early postoperative enteral and parenteral nutrition support in patients with gastric cancer.Methods 145 cases underwent surgery for gastric cancer,were randomly divided into parenteral nutrition PN group（48 cases）,enteral nutrition EN group（47 cases）,parenteral nutrition and enteral nutrition combined group（50 cases）.PN group was treated with parenteral nutrition support.EN group was treated with enteral nutrition support.The combined group were given parenteral nutrition and enteral nutrition support.The nutrition index,changes of humoral immunity and nutrition and clinical effect were observed.Results The postoperative nutritional indexes 7 dafter treatment the three groups were significantly increased（P〈0.05）,and patients in the combination group increased degree was significantly better than PN group and EN group（P〈0.05）.CD3^＋,CD4^＋ and CD4^＋/CD8^＋ levels significantly increased（P〈0.05）.CD8^＋T cells significantly decreased（P〈0.05）.The combination group improved degree as significantly better than that of PN group and en group（P〈0.05）.The anal exhaust time,postoperative hospitalization time and infection incidence of combination group were significantly lower than that in PN group and EN group（P〈0.05）.Conclusion The eowly postoperative entwral and ponenferal nuwition support in patients with gastrit cancer could improue nuwition cond,tion and imune function,shorten thtionp of hospital and enteral recovery and reduce the concidence of infecfion.