加速康复外科理念下肠内营养支持对腹腔镜胃癌根治术患者康复效果的影响

Effects of enteral nutrition support under the concept of fast track surgery on the rehabilitation effect of patients undergoing laparoscopic radical gastrectomy for gastric cancer

目的探讨加速康复外科理念下肠内营养支持对腹腔镜胃癌根治术患者康复效果的影响。方法将行腹腔镜胃癌根治术的156例胃癌患者按随机数字表法分为对照组、研究组,每组78例。对照组接受常规营养干预,研究组接受加速康复外科理念下肠内营养支持干预,观察住院全程。比较两组临床指标、住院期间并发症发生率及手术前后营养指标、术后2 d疼痛程度。结果研究组住院总费用显著少于对照组(P<0.01),术后首次排便、排气及住院时间显著短于对照组(P<0.01)。术后3 d两组血清白蛋白、前白蛋白水平显著低于术前(P<0.01),研究组显著高于对照组(P<0.01)。术后2 d研究组Ⅲ级疼痛占比显著低于对照组(P<0.01)。住院期间研究组肺部感染、伤口感染发生率显著低于对照组(P<0.05),两组并发症比较差异无统计学意义(P>0.05)。结论加速康复外科理念下肠内营养支持可改善腹腔镜胃癌根治术患者的营养状况,提高镇痛效果,降低肺部感染、伤口感染发生率,促进患者术后康复。

Objective To investigate the effect of enteral nutrition support under the concept of fast track surgery on the rehabilitation effect of patients undergoing laparoscopic radical gastrectomy for gastric cancer.Methods A total of 156 gastric cancer patients who underwent laparoscopic radical gastrectomy were divided into control group and study group according to random number table method,with 78 cases in each group.The control group received routine nutrition intervention,and the study group received enteral nutrition support intervention under the concept of fast track surgery,and the whole discharge process was observed.The clinical indicators,the incidence of complications during hospitalization,nutritional indicators before and after surgery,and the degree of pain 2 days after surgery were compared between the two groups.Results The total hospitalization cost in the study group was significantly lower than that in the control group(P<0.01),and the first defecation,exhaustion and hospital stay after the operation were significantly shorter than those in the control group(P<0.01).Three days after operation,the serum albumin(ALB)and prealbumin(PA)levels in the two groups were significantly lower than those before operation(P<0.01),and the study group was significantly higher than the control group(P<0.01).Two days after operation,the proportion of grade III pain in the study group was significantly lower than that in the control group(P<0.01).During hospitalization,the incidence of lung infection and wound infection in the study group was significantly lower than that in the control group(P<0.05).There was no significant difference in complications between the two groups(P>0.05).Conclusions Enteral nutrition support under the concept of fast track surgery can improve the nutritional indicators of patients undergoing laparoscopic radical gastrectomy for gastric cancer,improve the analgesic effect,reduce the incidence of lung infection and wound infection,and promote postoperative recovery.