老年胃癌患者术后早期肠内营养与肠外营养疗效的比较

Cost-effective comparison between early enteral nutrition and total parenteral nutrition on elder postoperative gastric cancer patients

目的探讨老年患者胃癌切除术后早期肠内营养的效果。方法回顾分析 1999年 7月至 2 0 0 2年 6月间 5 2例老年患者胃癌切除术后早期营养支持临床资料 ,本组 5 2例患者中 ,早期给予肠内营养 (earlyenteralnutrition ,EEN) 2 7例 ,术后第 1天开始TPN支持 2 5例。结果术后平均住院日EEN组较肠外营养 (totalparenteralnutrition ,TPN)组短 (16 3dvs 2 1 3d ,t=4 6 814 ,P <0 0 1) ,平均住院费用 /药物费用EEN、TPN组分别为 (10 5 6 3/ 4 15 1元vs136 4 0 / 6 12 6元 ,P <0 0 5 )。并发症发生率EEN组少于TPN组 ,差异有显著性 (P <0 0 5 )。TPN组治疗后肝功的碱性磷酸酶的水平高于治疗前 ,差异有显著性 (P <0 0 5 )。结论老年胃癌患者术后早期EEN支持可减少并发症 ,对肝功能影响小 ,费用低。

Objective To evaluate the cost-effectiveness of early enteral nutrition (EEN) in elder patients undergoing gastrectomy for gastric carcinoma. Methods An outcome-based retrospective review of 52 patients who had undergone gastrectomy for gastric carcinoma between July 1999 and June 2002 was performed .There were 27 patients in the EEN group, and 25 in the TPN group. Results The mean postoperative hospital days of the EEN group was significantly less than that of the TPN group (16.3 d vs. 21.3 d, t =4.6814, P <0.01). The mean cost of the EEN group was significantly less than that of the TPN group ($ 10 563 vs $ 13 640, P <0.05). The complication rates of the EEN group were lower than that of the TPN group( P <0.05).Postoperative hepatic AKP level in TPN group significantly elevated. Conclusion Early postoperative enteral nutrition after gastrectomy decreases the postoperative complication rate, and has less side effects on liver function.