早期整蛋白型和短肽型肠内营养在胃大部切除术后患者中的临床应用

Clinical application of early-stage whole protein and short peptide enteral nutrition in patients after subtotal gastrectomy

目的探讨早期整蛋白型和短肽型肠内营养在胃大部切除术后患者中的临床应用效果。方法选取2020年1月至2022年2月在该院行胃大部切除术的胃癌患者60例作为研究对象,以随机数字表法将患者分为对照组和观察组,每组30例。两组均行胃大部切除术,术后对照组和观察组分别给予早期整蛋白型和短肽型肠内营养支持。比较两组术后恢复情况相关指标,对两组术前和术后第8天营养指标[总蛋白(TP)、清蛋白(ALB)、血红蛋白(Hb)、前清蛋白(PA)、体质量指数(BMI)]进行比较,评估两组胃肠道耐受情况和并发症发生率。结果与对照组比较,观察组肠鸣音恢复、肛门排气排便、恶心呕吐缓解时间均明显较短(P<0.05);术后第8天两组TP、ALB、PA水平均有所改善,且观察组TP、ALB、PA水平改善情况均明显优于对照组(P<0.05),但术后第8天两组Hb、BMI水平差异均无统计学意义(P>0.05);观察组腹泻、腹胀发生率分别为13.33%、10.00%,均低于对照组的36.66%和33.33%(P<0.05);观察组和对照组并发症总发生率(13.33%vs.16.66%)比较差异无统计学意义(P>0.05)。结论给予行胃大部切除术胃癌患者短肽型肠内营养支持在改善患者营养状况方面的效果优于早期整蛋白型肠内营养支持,且肠道耐受性更好,具有较高的安全性。

Objective To investigate the clinical effect of early-stage whole protein and short peptide enteral nutrition after subtotal gastrectomy.Methods A total of 60 gastric cancer patients who underwent subtotal gastrectomy in the hospital from January 2020 to February 2022 were selected as the research objects,and were divided into control group and observation group by random number table method,with 30 cases in each group.Subtotal gastrectomy was performed in both groups,and the control group and the observation group were given early-stage whole protein-type and short-peptide enteral nutrition support,respectively.The postoperative recovery-related indicators of the two groups were compared,and the nutritional indicators,including total protein(TP),albumin(ALB),hemoglobin(Hb),prealbumin(PA)and body mass index(BMI)before and on the 8th day after operation were compared between the two groups,and the gastrointestinal tolerance and the incidence of complications were evaluated in the two groups.Results Compared with the control group,the recovery time of bowel sounds,anal flatus and defecation,nausea and vomiting in the observation group were significantly shorter(P<0.05).On the 8th day after operation,the levels of TP,ALB and PA in both groups were improved,and the improvement of the levels of TP,ALB and PA in the observation group were significantly better than that in the control group(P<0.05),but there were no significant differences in the levels of Hb and BMI between the two groups on the 8th day after operation(P>0.05).The incidence rates of diarrhea and abdominal distension in the observation group were 13.33%and 10.00%,which were lower than 36.66%and 33.33%in the control group(P<0.05).The difference in the total incidence of complications between the observation group and the control group(13.33%vs.16.66%)was not statistically significantly(P>0.05).Conclusion Short peptide enteral nutrition support for gastric cancer patients undergoing subtotal gastrectomy is more effective than early-stage whole protein enteral nutrition support in improving the nutritional status of patients,and has better intestinal tolerance and relatively high safety.