经鼻-空肠肠内营养对胃癌根治术后患者营养状况、炎症反应及并发症的影响

Effects of nutrients via transnasal-jejunal canal on nutritional status,inflammatory responses,and complications of patients after radical gastric cancer surgery

目的探究经鼻-空肠营养管对胃癌根治术患者营养指标、炎症反应及并发症的影响。方法82例行胃癌根治术患者均分为实验组和对照组,实验组术后采用经鼻-空肠营养管行肠内营养支持,对照组术后采用中心静脉置管行肠外营养支持;比较2组患者术前、术后第8天时的血清白蛋白(ALB)、转铁蛋白(TFN)、前白蛋白(PA)、血红蛋白(Hb)水平等营养学指标和血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)等炎症因子水平,比较2组患者术后首次排气时间、排便时间、下床时间、住院时间、消化道出血、腹腔出血、切口感染及肺部感染等并发症发生情况。结果术后第8天,2组患者ALB、TFN、PA、Hb水平均较术前有所提高,且实验组ALB、TFN、PA、Hb水平明显高于同时点对照组,差异有统计学意义(P<0.05);与对照组比较,实验组术后首次排气时间、排便时间及下床时间明显提前,住院时间明显缩短,差异有统计学意义(P<0.05);术后第8天,2组患者血清IL-6、TNF-α、CRP水平均高于手术前,但实验组L-6、TNF-α、CRP水平均低于对照组,差异有统计学意义(P<0.05);实验组并发症总发生率17.07%,低于对照组的26.83%,差异有统计学意义(P<0.05)。结论胃癌根治术患者行鼻-空肠营养管肠内营养支持,可改善患者营养状况、减轻炎症反应、降低并发症。

Objective To explore effects of nutrients via transnasal-jejunal canal on nutritional status,inflammatory responses and complications of patients after radical gastric cancer surgery.Methods Eighty-two patients undergoing radical gastric cancer surgery were divided into experimental group and control group.Patients in the experimental group received enteral nutrition supported by intranasal jejunal nutrition tube after operation,while patients in the control group received parenteral nutrition supported by central venous catheterization after operation.The expression differences of nutritional indicators such as serum albumin(ALB),transferrin(TFN),prealbumin(PA),and hemoglobin(Hb)and inflammatory factors such as serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)before and on the 8 th day after operation were compared between the two groups;The differences of first postoperative exhaust time,defecation time,time of getting out of bed and length of hospital stay between the two groups were compared;The differences incidence of postoperative complications such as gastrointestinal bleeding,abdominal bleeding,incision infection and pulmonary infection was compared between the two groups.Results On the 8 th day after surgery,the levels of ALB,TFN,PA,and Hb of two groups were increased relative to those before surgery.The levels of ALB,TFN,PA,and Hb of experimental group were significantly higher than those of control group at the same time points(P<0.05).Compared to control group,the time of first anal exhaust,defecation,and getting out of bed in experimental group was significantly earlier than control group after surgery,and the hospital stay was significantly shortened in experimental group relative to control group(P<0.05).On the 8 th day after surgery,the levels of IL-6,TNF-α,and CRP in the two groups were higher than before surgery,but they were significantly lower in experimental group than those in control group(P<0.05).The total incidence rate of complications in experimental group was 17.07%,lower than 26.83%in control group(P<0.05).Conclusion Nutrients via transnasal-jejunal canal can improve the nutritional status of patients after radical gastrectomy,reduce inflammation and complications.