老年胃癌病人胃切除术后对早期口服营养的耐受性研究

Tolerance of early oral nutrition in elderly patients with gastric cancer after gastrectomy

目的 探讨胃切除术后老年病人对早期口服营养的耐受性。方法 2017年1月~2020年12月间接受胃切除术的胃癌病人117例。所有病人在术后第1天接受口服饮食。将病人分为年龄>70岁和年龄≤70岁的两组,比较短期结果和口服营养不耐受性。结果 117例病人中,21例(17.9%)对早期口服营养不耐受,其中14例年龄≤70岁,7例年龄>70岁。引起不耐受的最常见症状是腹胀。发生不耐受后的平均禁食时间为(2.8±2.4)天。年龄>70岁和年龄≤70岁组不耐受发生率分别为17.1%和18.4%,两组比较差异无统计学意义(P>0.05)。术后年龄>70全身并发症发生率较高,差异有统计学意义;两组吻合口并发症发生率比较,差异无统计学意义(P>0.05)。结论 胃切除术后早期口服营养的不耐受性在年龄>70和年龄≤70岁病人之间没有显著差异。表明早期口服营养可以安全地用于接受胃切除术的老年病人。

Objective To investigate the tolerance of elderly patients to early oral nutrition after gastrectomy.Methods 117 patients with gastric cancer who underwent indirect gastrectomy from January 2017 to December 2020 were analyzed retrospectively.All patients received oral diet on the first day after operation.Patients were divided into older(>70 years) and younger(≤70 years) adult groups to compare short-term results and oral nutritional intolerance.Results Among 117 patients, 21 cases(17.9%) were intolerant to early oral nutrition, including 14 cases≤70 years old and 7 cases>70 years old.The most common symptom of intolerance is abdominal distension.The mean fasting time after intolerance was(2.8±2.4)days.The incidence of intolerance was 17.1% in the elderly group and 18.4% in the young group(P>0.05).There was no significant increase in intolerance in gender, surgical methods, lymph node dissection and tumor staging subgroups.The incidence of systemic complications was higher in the elderly group;There was no significant difference in anastomotic complications between the two groups(P>0.05).Conclusion There was no significant difference in oral nutrition intolerance between elderly and young adult patients.It shows that early oral nutrition can be safely used in elderly patients undergoing gastrectomy.