胃癌全胃切除术后患者行家庭肠内营养的可行性研究

The Feasibility of Family Enteral Nutrition After Total Gastrectomy for Gastric Cancer

目的:探讨和研究胃癌全胃切除术后患者行家庭肠内营养的可行性。方法:选取河北北方学院附属第一医院2014年2月—2018年2月收治的胃癌全胃切除术患者72例,随机分为观察组38例和对照组34例,两组患者术后在院内均经鼻空肠营养管行肠内营养支持,对照组出院后拔除鼻空肠营养管,观察组继续保留肠内营养支持,持续时间为4w。观察和比较两组出院时或出院后4w各营养指标和生活质量指标变化。结果:两组出院时体重下降和上臂围测量值以及血清总蛋白、白蛋白和血红蛋白指标无明显差异(P>0. 05),出院后4w观察组体重下降值明显低于对照组(P <0. 05),上臂围测量值和血清总蛋白、白蛋白、血红蛋白指标明显高于对照组(P <0. 05或P <0. 01)。出院后4w观察组功能状态(KPS)评分、生活质量指数(QLI)和EORTC OLQ—C30量表指标明显优于对照组(P <0. 05或P <0. 01)。结论:胃癌全胃切除患者行家庭肠内营养支持能明显改善患者不良营养状况和提高生活质量,安全性高,值得在临床上推广使用。

Objective To explore and study the feasibility of family enteral nutrition after total gastrectomy for gastric cancer.Method A total of 72 patients with total gastrectomy were selected from our hospital from February 2014 to February 2018,and a total of 72 patients were randomly divided into 38 in observation group and 34 in control group.The two groups of patients received nutritional support in the hospital after surgery,after discharge from the control group,the nasal jejunal nutrition tube was removed and the observation group continued to retain enteral nutrition support for 4 weeks.The changes of nutrition indicators and quality of life in two groups after discharge or 4 weeks after discharge were observed and compared.Result There was no significant difference in weight loss and upper arm circumference measurements between the two groups,as well as serum total protein,albumin and hemoglobin(P>0.05).The weight loss of the observation group was significantly lower than that in the control group 4 weeks after discharge(P<0.05).The measurements of upper arm circumference and serum total protein,albumin and hemoglobin were significantly higher than those in the control group(P<0.05/P<0.01).4 weeks after discharge,the functional status(KPS)score,QLI and EORTC olq-c30 scale were significantly better than those in the control group(P<0.05/P<0.01).Conclusion The family enteral nutrition support can obviously improve the patients poor nutrition status and improve the quality of life,the safety is high,and it is worth populating in clinical practice.