肠外营养与肠内营养支持对根治性全胃切除术后胃肠功能的影响

Effects of parenteral nutrition and enteral nutrition support on gastrointestinal function after radical total gastrectomy

目的探讨肠外营养与肠内营养支持对根治性全胃切除术后胃肠功能影响。方法回顾性选取2012年10月至2017年6月我院收治的根治性全胃切除术患者58例,根据治疗营养支持方法不同分为对照组和观察组。对照组患者采用肠外营养支持治疗,观察组患者采用肠内营养支持治疗。观察两组患者治疗后排气和排便恢复时间、住院时间、并发症情况、营养状况、生长激素、免疫功能和肝功能水平变化情况。结果观察组患者排气、排便恢复时间及住院时间均短于对照组(P<0.05)。对照组患者治疗后血清总蛋白、前清蛋白及转铁蛋白水平均较治疗前下降,生长激素水平较治疗前上升(P<0.05)。观察组患者治疗后血清总蛋白、前清蛋白及转铁蛋白水平与治疗前比较无统计学差异(P>0.05),生长激素水平较治疗前升高(P<0.05)。两组患者治疗后营养指标和生长激素水平比较有统计学差异(P<0.05)。对照组患者治疗后RBC-C3rbR水平较治疗前下降,RBC-ICR、ALT及AST水平较治疗前上升(P<0.05)。观察组患者治疗后RBC-C3rbR水平较治疗前上升,RBC-ICR水平较治疗前下降(P<0.05),但ALT和AST水平与治疗前比较无统计学差异(P>0.05)。两组患者治疗后免疫功能和肝功能水平比较有统计学差异(P<0.05)。观察组患者并发症发生率为3%低于对照组(P<0.05)。结论肠内营养支持有利于根治性全胃切除术后患者胃肠功能的恢复,可改善患者营养状况,提高患者免疫功能,且安全性高。

Objective To investigate the effect of parenteral nutrition and enteral nutrition support on gastrointestinal function after radical total gastrectomy. Methods Review from October 2012 to June 2017 in our hospital of total gastrectomy in 58 cases was conducted. According to the treatment methods of nutritional support they were divided into control group and observation group. The control group was treated with parenteral nutrition support treatment,observation group were treated by enteral nutrition support treatment. Observe two groups of patients after treatment for exhaust and defecation recovery time,the hospitalization time,complications,nutritional status,growth hormone,changes of immune function and liver function. Results Patients in the observation group had exhaust,defecation recovery time and hospitalization time shorter than the control group（ P〈0. 05）. The serum total protein. prealbumin and transferrin levels after treatment in control group,were lower than that before treatment,the level of growth hormone was increased compared with before treatment（ P〈0. 05）. The serum total protein. prealbumin transferrin levels in patients of observation group after treatmentwas not different from that before treatment（ P〉0. 05）,growth hormone levels were higher than before treatment（ P〈0. 05）. Two groups of patients after treatment,the nutritional indexes and growth hormone levels were statistically significant difference（ P〈0. 05）. The patients in the control group after treatmentthe level of C-C3 rbR was decreased compared with that before treatment,RBC-ICR,ALT and AST levels were increased compared with that before treatment（ P〈0. 05）. Patients in the observation group after treatment the level of RBC-C3 rbR was increased compared with that before treatment,the level of RBC-ICR decreased（ P〈0. 05）,but ALT and AST levels had no significant difference compared to before treatment（ P〈0. 05）. The immune function and liver function were significantly different between two groups（ P〈0. 05）. The complication rate of observation group was 3% lower than that of the control group（ P〈0. 05）. Conclusion The enteral nutrition support is beneficial to the recovery of gastrointestinal function after radical total gastrectomy,and can improve the nutritional status of patients and improve the immune function of patients,and the safety is high.