3D腹腔镜胃癌根治术后联合使用肠内外营养支持的近期疗效观察

Short-term efficacy of combined parenteral and enteral nutrition support after 3D laparoscopic radical gastrectomy

目的探讨3D腹腔镜胃癌根治术后使用肠内外营养联合支持的近期疗效。方法选取本院2015年1月至2019年6月收治的胃癌患者100例,按照术后营养支持方式不同,分为对照组和观察组,各50例。两组患者均行3D腹腔镜胃癌根治术,对照组术后给予肠外营养支持,观察组术后给予肠内外营养联合支持。比较两组术后首次通气时间、排便时间、住院时间及治疗费用,术后7 d血清ALB、PAB、CRP以及BMI变化、临床并发症情况。结果观察组患者术后首次通气时间、排便时间、住院时间及治疗费用均显著少于对照组(P<0.05);术后7 d,两组ALB水平与术前比较差异无统计学意义,PAB、CRP水平均升高,BMI均下降(P<0.05);观察组患者术后7 d PAB水平及BMI高于对照组,CRP水平低于对照组(P<0.05);两组术后并发症发生率比较差异无统计学意义。结论3D腹腔镜胃癌根治术后给予肠内外营养可有效促进患者胃肠功能恢复,缩短住院时间,降低治疗费用,改善机体营养状况,降低炎症反应程度,近期疗效显著,值得临床推广和应用。

Objective To investigate the short-term effect of combined parenteral and enteral nutrition support after 3D laparoscopic gastrectomy.Methods 100 patients with gastric cancer admitted to our hospital from January 2015 to June 2019 were selected.According to the different ways of postoperative nutritional support,the patients were divided into control group and observation group,with 50 cases in each group.Two groups of patients underwent three-dimensional laparoscopic radical gastrectomy for gastric cancer.The control group received parenteral nutrition support after operation,while the observation group received combined parenteral nutrition support after operation.The first ventilation time,defecation time,hospitalization time and treatment cost,changes of serum ALB,PAB,CRP,BMI and clinical complications were compared between the two groups 7 days after operation.Results The first ventilation time,defecation time,hospitalization time and treatment cost in the observation group were significantly less than those in the control group(P<0.05).There was no significant change in ALB level in the two groups 7 days after operation,the levels of PAB and CRP increased,and BMI decreased(P<0.05).The levels of PAB and BMI in the observation group were significantly lower than those in the control group 7 days after operation(P<0.05).The CRP level was lower than that of the control group(P<0.05).There was no significant difference in postoperative complications between the two groups.Conclusion Enteral and parenteral nutrition after laparoscopic radical gastrectomy can effectively promote the recovery of gastrointestinal function,shorten hospitalization time,reduce treatment costs,improve the nutritional status of the body and reduce the degree of inflammatory reaction.The short-term effect is remarkable,which is worthy of promotion and application.