腹腔镜胃癌术后早期长疗程经口与经鼻空肠管营养的比较

A Comparison of Early and Long Course of Oral and Nasojejunal Nutrition after Laparoscopic Surgery for Gastric Cancer

目的观察早期长疗程经口饮食与经鼻空肠营养管营养对腹腔镜胃癌术后临床疗效的影响。方法选取2018年2月~2021年1月在江南大学附属医院胃肠外科行腹腔镜手术的胃癌患者106例,采用随机数字表法分为早期经口饮食组(n=53)及早期鼻饲营养组(n=53),统计两组术后1周反应营养状况的主要指标、术后主要并发症和术后恢复相关指标、给予肠内营养剂后主要不耐受症状的发生情况。结果早期经口饮食组给予肠内营养剂后恶心(P=0.038)、咽痛(P=0.028)、咽喉部异物感(P<0.001)发生率较早期鼻饲营养组显著降低,两组腹胀(P=0.632)、腹泻(P=0.620)比较,差异均无统计学意义;两组术后1周PG-SGA评分、血红蛋白、白蛋白、转铁蛋白、前白蛋白比较,差异均无统计学意义(P>0.05);两组术后消化道漏、术后出血、术后感染、胃排空延迟、乳糜漏比较,差异均无统计学意义(P>0.05);早期经口饮食组营养总费用明显低于早期鼻饲营养组(P<0.001),但两组住院总费用、术后首次肛门排气时间、术后住院天数比较,差异均无统计学意义(P>0.05)。结论早期长疗程经口肠内营养与经鼻空肠营养管肠内营养疗效相当,它能改善恶心、咽喉痛、咽喉部异物感的插管相关不良反应。

Objective To observe the effect of early and long course of oral feeding and early and long course of nasal feeding through nasojejunal nutrition tube on the clinical efficacy of postoperative laparoscopic gastric cancer.Methods A total of 106 patients with gastric cancer who underwent laparoscopic surgery in the department of gastrointestinal surgery of Jiangnan University Affiliated Hospital from February 2018 to January 2021 were selected as the research subjects,and divided into early oral feeding group(n=53)and early nasal feeding group(n=53)by random table method.Statistics of the occurrence of the main indicators of nutritional status,major postoperative complications,postoperative recovery related indicators and the major discomfort symptoms after enteral nutrition of the two groups.Results The incidence of nausea(P=0.038),sore throat(P=0.028)and foreign body sensation in the throat(P<0.001)in the early oral diet group was significantly lower than that in the early nasal feeding group,but there was no significant difference in abdominal distention(P=0.632)and diarrhea(P=0.620)between the two groups.There were no significant differences in PG-SGA,hemoglobin,albumin,transferrin and prealbumin between the two groups at one week after surgery(P>0.05).There were no significant differences in the complications of anastomotic leakage,postoperative hemorrhage,postoperative infection,delayed gastric emptying and chylous leakage between the two groups(P>0.05).The total nutrition cost of the early oral feeding group was significantly lower than that of the early nasal feeding group(P<0.001),but there were no significant differences in the total hospital cost,the first postoperative anal exhaust time and the postoperative hospital stay between the two groups(P>0.05).Conclusion Early and long course of laparoscopic enteral nutrition feeding through oral and nasal jejunal nutrition tube after postoperative gastric cancer has the same efficacy,but oral feeding can improve the nausea,sore throat,throat foreign body sensation related side effects of intubation.