全胃切除围手术期的肠内和肠外营养联合应用

<title>Application of combination of parenteral nutrition with enteral nutrition in perioperative period of total gastrectomy

目的 探讨肠内营养(EN)和肠外营养(PN)联合应用在全胃切除围手术期的治疗作用。方法 52例进展期胃癌中41例术前即给予PN支持;所有病人在全胃切除术后均给予PN,待肠功能恢复后转为EN。结果 48例(92.3%)术后3d内肠功能恢复。EN期间,5例(9.6%)出现肠鸣、腹痛或轻度腹泻,经减慢营养液滴入速度后症状逐渐缓解。术后第10d血浆白蛋白与术前比较明显增加(P<0.01);所有病人术后第10d达到了正氮平衡。结论 PN与EN联合营养可改善病人的营养状态,降低营养费用,是全胃切除围手术期较理想的营养治疗方式。

<Abstrcat>ObjectiveTo determine the effects of combination of parenteral nutrition(PN) with enteral nutrition (EN) on patients with gastric cancer in perioperative period of total gastrectomy . MethodsIn 52 patients with advanced gastric cancer, 41 had PN support preoperatively and all 52 patients received combination of PN with EN after the total gastrectomy. Results48 of the 52 patients whose intestinal function was recovered within 3 days postoperatively. When using EN, 5 cases felt borborygmus,abdominal pain or mild diarrhea, but these symptoms decreased by slowing down of the infusion speed. The concentration of plasma albumin showed a marked increase on the 10th postoperative day(P<0.01).All patients showed positive nitrogen balance on the 10th postoperative day. ConclusionsThe combination of PN with EN support is an ideal nutritional treatment in perioperative period of total gastrectomy, because it can improve nutritional state of the patients and reduce the medical cost.