胃癌术后早期肠内营养对减少手术并发症的影响

Effect of early enteral nutrition support on reducing complications after gastric cancer operation

目的探讨胃癌术后早期肠内营养对减少手术并发症的影响。方法选择2017年10月~2018年10月潍坊市人民医院普通外科收治的74例实施D2根治术的进展期胃癌患者,随机分为实验组和对照组,其中实验组患者早期进行肠内营养(38例),对照组患者排气排便后进行肠内营养(36例)。2组患者分别于术前1d、术后1d、术后3d、术后7d清晨空腹8h以上抽取前臂静脉血白蛋白(ALB)、血清前白蛋白(PAB)、血红蛋白(HB)、血肌酐(BUN)、转铁蛋白(TRF)等进行对比分析。结果术后1d、术后3d、术后7d的C-反应蛋白值、术后1d、术后3d、术后7d的血白细胞数量均有统计学差异(P<0.05),且实验组在效果上优于对照组;术后第7天PAB、术后第3天、第7天的ALB、术后第7天的HB、术后第1天、第3天、第7天的TRF、术后第7天的BUN值存在统计学差异(P<0.05),且实验组营养指标状况优于对照组。结论胃癌患者术后早期积极给予肠内营养支持能明显改善患者术后的营养状况,减少应激反应对术后的影响,促进快速康复。

Objective To investigate the effect of early enteral nutrition on reducing postoperative complications of gastric cancer.Methods Seventy-four patients with advanced gastric cancer who underwent D2 radical surgery admitted to the General Surgery of Weifang People’s Hospital,ranged from October 2017 to October 2018 were enrolled.Random number table method was performed according to the order of admission and divided into experimental group and control group.The experimental group was treated with enteral nutrition in the early stage(38 cases),and the control group was treated with enteral nutrition after defecation(36 cases).Albumin(ALB),serum prealbumin(PAB),and hemoglobin(HB),coupled with serum creatinine(BUN) and transferrin were respectively detected 1 day before,1,3,and 7 days after the surgery.Results There are statistically significant differences in the values of c-reactive protein and the amount of leukocytes,detected 1 day,3 days and 7 days after the surgery respectively(P<0.05),better than the control group.After the operation,PAB on the 7 th day,ALB on the 3 rd and 7 th day,HB on the 7 th day,TRF on the 1 st,3 rd,and 7 th day,BUN on the 7 th day after surgery,there was statistically significant difference(P<0.05),and the nutritional indicators of the experimental group were better than the control group.Conclusion Active administration of enteral nutrition support for patients with gastric cancer operation can significantly improve the nutritional status,reduce the impact of postoperative stress response,and promote rapid recovery.