补充性肠外营养在全胃切除术后应用的必要性研究

Necessity of supplementary parenteral nutrition after total gastrectomy

目的探索全胃切除术后营养支持的最佳模式。方法对全胃切除术后患者随机进行肠内序贯营养(PN+EN)、早期肠内营养(TEN)、全肠外营养(TPN)方案营养支持,对比3组患者术后营养指标和并发症等。结果 PN+EN患者营养指标恢复较好;TPN组患者费用高且术后对肝功能影响较大;TEN组发生腹痛、腹胀、一过性肠梗阻的并发症高于其余2组。结论恰当的PN+EN治疗是全胃切除术后患者最佳营养治疗方案。

Objective To explore for the optimal modality of nutritional support after total gastrectomy. Methods Following total gastrectomy, the patients were randomized to receive different nutritional support regimens： se-quential parenteral and enteral nutritional（PN ＋EN）, early total enteral nutrition（TEN） and total parenteral nutrition（TPN）. The nutritional indices and complications in the three groups were compared. Results The patients on PN＋EN showed better nutritional indices. The patients on TPN suffered higher medical cost and greater impairment of liv-er function. Those on TEN experienced more complications including abdominal pain, distension, and transient bowel obstruction compared with the other two groups. Conclusion Proper use of PN＋EN may be the optimal nutritional therapy for patients after total gastrectomy.