Effect of Sequential Early Enteral Nutrition on Postoperative Rehabilitation and Complications in Gastric Cancer Patients

Objective:To analyze the effect of sequential early enteral nutrition in patients with gastric cancer after surgery.Methods:A total of 139 gastric cancer patients,treated between October 2021 and October 2023,were randomly selected and divided into two groups:Group A(68 cases,receiving early enteral nutrition)and Group B(71 cases,receiving sequential early enteral nutrition),using computer randomization.The effects of the interventions on both groups were compared.Results:Seven days post-operation,the levels of nutritional indicators in Group B were significantly higher than those in Group A(P<0.05).Group B showed significantly better levels of inflammatory factors and immune factors compared to Group A seven days post-operation(P<0.05).The postoperative complication rate in Group B was 4.23%,2 significantly lower than that in Group A,which was 16.18%(χ=5.477,P=0.019).Conclusion:The utilization of sequential early enteral nutrition in gastric cancer patients after surgery demonstrated notable improvements in nutritional status and inflammation markers,along with enhanced immunity,effectively reducing postoperative complications.

Effect of preoperative nutrition therapy type and duration on short-time outcomes in gastric cancer patient with gastric outlet obstruction

Objective:To avoid perioperative complications caused malnutrition,nutrition therapy is necessary in gastric outlet obstruction(GOO)patients.Compared to parenteral nutrition(PN),enteral nutrition(EN)is associated with many advantages.This study aimed to investigate whether preoperative EN has beneficial clinical effects compared to preoperative PN in gastric cancer patients with GOO undergoing surgery.Methods:According to the methods of preoperative nutrition therapy,143 patients were divided into EN group(n=42)and PN group(n=101)between January 2013 and December 2017 at the Chinese People’s Liberation Army General Hospital.Multiple logistic regression models were used to assess the association between the methods of preoperative nutrition therapy and postoperative day of flatus passage.The generalized additive model and twopiecewise linear regression model were used to calculate the inflection point of the preoperative nutritional therapy time on the postoperative day of flatus passage in the PN group.Results:EN shortened the postoperative day of flatus passage in gastric cancer patients with GOO,which is a protective factor,especially in patients who underwent non-radical operations and the postoperative day of flatus passage reduced when the preoperative PN therapy was up to 3 d and a longer PN therapy(>3 d)did not accelerate the postoperative recovery of gastrointestinal functions.Conclusions:Preoperative EN therapy would benefit gastric cancer patients with GOO by accelerating postoperative recovery.For patients with absolute obstruction,no more than 3-day PN therapy is recommended if patients can tolerate general anesthesia and surgery.

Difference in the effects of three nutritional pathways on postoperative rehabilitation in patients with gastric cancer and type 2 diabetes mellitus

Objective To explore the difference in the effects of three nutritional pathways on the rehabilitation of patients with gastric cancer and diabetes mellitus after operation.Methods Overall,120 patients were randomly divided into the partial parenteral nutrition(PPN),early enteral nutrition(EEN),and diabetes mellitus special enteral nutritional emulsion(DEN)groups.The differences in the effects of three nutritional modes were compared.Results(1)On postoperative day four,the total protein level in the EEN and DEN groups was significantly higher than that in the PPN group(P<0.05).On postoperative day ten,body mass index,lymphocyte count,total protein level,and pre-albumin level in the DEN group were significantly higher than those in the PPN group(P<0.05).(2)On postoperative day four,there was no significant difference in the fasting blood glucose level between the EEN and DEN groups(P>0.05),but this level was significantly lower than that in the PPN group(P<0.05).On postoperative day ten,fasting and postprandial blood glucose levels in the DEN group were significantly lower than those in the PPN group.(3)On postoperative day four,the C-reactive protein level in the DEN group was significantly lower than that in the other groups(P<0.05).(4)The incidence rates of complications in the PPN,EEN,and DEN groups were 25.0%,10.0%,and 5.0%,respectively.The incidence of complications in the PPN group was significantly higher than that in the other groups.However,there was no significant difference in perioperative indexes among the three groups(P>0.05).Conclusion Enteral nutrition is more conducive to the recovery of patients with gastric cancer and type 2 diabetes mellitus after operation;the special enteral nutrition emulsion for diabetes mellitus is more effective than the conventional nutrition solution in stabilizing blood sugar levels and reducing the degree of inflammation.

Short-term effects of supplementary feeding with enteral nutrition via jejunostomy catheter on post-gastrectomy gastric cancer patients

Background Most gastric cancer patients who undergo gastrectomy develop malnutrition. It is, therefore, crucial to establish an effective means to provide nutrition for these patients. To perform home enteral nutrition （EN） to ensure adequate nutritional intake in gastric cancer patients, we placed a jejunostomy catheter during gastric surgery. Most patients showed improved nutritional status. Methods Twenty-nine inpatients at our hospital underwent radical gastrectomy and jejunostomy from December 2002 to December 2007 and were designated as the jejunostomy group, and 32 matched patients without a jejunostomy tube were designated as the tube-free group. The jejunostomy group was treated with EN from 72 hours to 3 months postoperatively. The tube-free group did not receive EN. Data including preoperative and postoperative body weight, body mass index （BMI）, nutrition risk screening （NRS） score, Karnofsky performance score （KPS）, and laboratory biochemical indicators were documented respectively and compared. Results Compared with preoperative week 1, both groups showed decreased body weight and BMI at 3 months postoperatively. The weight loss in the jejunostomy group （（7.1±3.3） kg） was significantly less than that in the tube-free group （（9.9±3.1） kg）. Similarly, BMI decreased by （2.4±1.0） kg/m2 in the jejunostomy group, which was significantly less than in the tube-free group （（3.2±0.9） kg/m2）. The number of patients with postoperative NRS 〉3 was decreased in the jejunostomy group, but was increased in the tube-free group, and this difference was significant. There were no significant differences between the two groups in total lymphocyte count, hemoglobin, albumin and prealbumin, and adverse drug effects. Conclusions Short-term （3 months） EN supplementation via jejunostomy tube can reduce the risk of malnutrition and weight loss, and improve tolerance of chemotherapy. Tube feeding is reliable for achieving these goals because it is not important whether or not the oatients have appetites.

Effect of Sijunzi decoction combined with nutritional support after gastric cancer surgery on the stress inflammatory response and immune response

Objective:To study the effect of Sijunzi decoction combined with nutritional support after gastric cancer operation on the stress inflammatory response and immune response.Methods:Patients who received radical operation for gastric cancer in West China Hospital between March 2015 and August 2017 were selected and randomly divided into the observation group who accepted Sijunzi decoction combined with enteral nutrition support after operation and the control group who accepted routine enteral nutrition support after operation. The stress inflammatory response indexes in serum and the immune response indexes in peripheral blood were measured before operation and 3 d after operation.Results: 3 d after operation, Cor, Gluc, Ins, O2-, CRP, TNF-α, YKL-40, MK and IL-6 contents in serum as well as GATA-3, RORγt and Foxp3 expression in peripheral blood of both groups were higher than those before operation whereas HO-1 and SOD contents in serum as well as CD3+CD4+T cell, CD3+CD8+T cell, CD16+CD56+NK cell and CD19+B cell contents and T-bet expression in peripheral blood were lower than those before operation, and Cor, Gluc, Ins, O2-, CRP, TNF-α, YKL-40, MK and IL-6 contents in serum as well as GATA-3, RORγt and Foxp3 expression in peripheral blood of observation group were lower than those of control group whereas HO-1 and SOD contents in serum as well as CD3+CD4+T cell, CD3+CD8+T cell, CD16+CD56+NK cell and CD19+B cell contents and T-bet expression in peripheral blood were higher than those of control group.Conclusion: Sijunzi decoction combined with nutritional support after gastric cancer operation can reduce the stress inflammatory response and enhance the immune response.

附子理中汤联合足三里穴位注射配合循经热熨法对腹腔镜胃癌术后(脾胃虚寒证)患者胃肠激素、炎症反应、营养参数和血清MIP-3α、Stathmin的影响

目的:观察附子理中汤联合足三里穴位注射配合循经热熨法对腹腔镜胃癌术后(脾胃虚寒证)患者胃肠激素、炎症反应、营养参数和血清微管解聚蛋白(Stathmin)、巨噬细胞炎性蛋白-3α(MIP-3α)的影响。方法:选择2021年1月至2023年3月该院收治的胃癌患者126例,分组方式为随机数字表法。对照组42例患者(脱落2例,最终纳入40例)给予常规西医治疗,观察1组42例患者(脱落3例,最终纳入39例)在对照组的基础上给予足三里穴位注射配合循经热熨法治疗,观察2组42例患者(脱落2例,最终纳入40例)在观察1组的基础上给予附子理中汤治疗。比较三组患者的临床疗效,记录肛门首次排气时间、首次经口进食时间和首次排便时间;术后1、15 d测定三组患者营养参数(血清血红蛋白、转铁蛋白和白蛋白),检测炎症反应指标[血红素加氧酶-1(HO-1)、缺氧诱导因子-1α(HIF-1α)和白细胞介素6(IL-6)]、胃肠激素指标[胃泌素17(G-17)、胃动素(MTL)]及MIP-3α、Stathmin水平。结果:观察1组、观察2组患者的总有效率分别为94.87%(37/39)、97.50%(39/40),高于对照组的75.00%(30/40),差异有统计学意义(P<0.05);而观察2组与观察1组患者总有效率的差异无统计学意义(P>0.05)。观察2组患者肛门首次排气时间、首次经口进食时间和首次排便时间短于对照组、观察1组,且观察1组患者短于对照组,差异均有统计学意义(P<0.05)。术后15 d,观察2组患者转铁蛋白、血红蛋白和白蛋白水平高于对照组、观察1组,且观察1组患者高于对照组;观察2组患者HO-1、HIF-1α和IL-6水平低于对照组、观察1组,且观察1组患者低于对照组;观察2组患者G-17、MTL水平高于对照组、观察1组,且观察1组患者高于对照组;观察2组患者Stathmin、MIP-3α水平低于对照组、观察1组,且观察1组患者低于对照组,上述差异均有统计学意义(P<0.05)。结论:附子理中汤联合足三里穴位注射配合循经热熨法治疗腹腔镜胃癌术后患者,可减少炎症反应,调节胃肠激素和营养参数,降低Stathmin、MIP-3α水平,促进疾病康复,提高临床疗效。

大承气汤加减联合肠内营养支持对胃癌根治术后患者胃肠功能、免疫功能及营养状况的影响

目的探讨大承气汤加减联合肠内营养支持对胃癌根治术后患者胃肠功能、免疫功能及营养状况的影响。方法回顾性分析2020年6月—2022年6月该院接诊的62例胃癌根治术患者的诊疗情况,按治疗方法不同分为观察组和对照组各31例。对照组患者采取肠内营养治疗,观察组在此基础上给予大承气汤加减治疗,两组均接受1周的连续治疗。比较两组患者的术后排便时间、肛门排气时间、肠鸣音恢复时间、首次进食时间,治疗1周后,比较两组患者治疗前后T淋巴细胞亚群水平(CD^(+)_(4)、CD^(+)_(8)、CD^(+)_(4)/CD^(+)_(8))、免疫球蛋白[免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)]、营养指标[血红蛋白(hemoglobin,Hb)、前白蛋白(prealbumin,PAB)、人血清白蛋白(human serum albumin,HSA)、转铁蛋白(transferrin,TRF)]的水平变化及并发症情况。结果治疗后,观察组在排便时间、肛门排气时间、肠鸣音恢复时间、首次进食时间均明显短于对照组(P<0.05);治疗后,观察组CD^(+)_(4)、CD^(+)_(8)、CD^(+)_(4)/CD^(+)_(8)、IgA、IgG、IgM、Hb、PAB、HSA、TRF水平均明显高于对照组(P<0.05);治疗期间,观察组的并发症发生率明显低于对照组(P<0.05)。结论大承气汤加减联合肠内营养支持能有效改善胃癌根治术后患者胃肠功能、免疫功能,促进营养状况的恢复,值得在临床中进行推广。

赋能教育联合肠内营养剂对胃癌化疗患者营养状况的影响

目的探讨赋能教育联合肠内营养剂对胃癌化疗患者营养状况的影响。方法随机抽取福建医科大学肿瘤临床医院2022年2月—2023年2月收治的100例胃癌化疗患者作为研究对象。按照护理方法不同将患者分为试验组与对照组,各50例。2组采用常规胃癌化疗,对照组给予胃癌患者肠内营养剂辅助,试验组采用赋能教育联合肠内营养剂的方法。比较2组血清蛋白水平、营养状况、不良反应发生情况、生活质量评价。结果护理后,试验组总蛋白、白蛋白、前白蛋白、血红蛋白及体质量分别为(74.82±4.21)g/L、(46.82±3.71)g/L、(4.31±0.71)g/L、(128.81±10.41)g/L、(72.12±12.17)kg,均高于对照组的(70.89±4.91)g/L、(42.91±5.10)g/L、(3.54±0.68)g/L、(122.84±8.31)g/L、(65.94±9.08)kg(P<0.05)。护理后,试验组患者主观整体评估(patient-generated subjective global assessment,PG-SGA)评分为(1.55±0.41)分,低于对照组的(3.22±0.75)分(P<0.05)。试验组不良反应总发生率为4.00%,低于对照组的26.00%(P<0.05)。护理后,试验组生活质量评分低于对照组(P<0.05)。结论胃癌化疗患者给予赋能教育联合肠内营养剂干预,能够改善血清蛋白及营养水平,提高生活质量的同时能够减少不良反应。

胃癌病人围术期营养管理方案的构建

目的:构建胃癌病人围术期营养管理方案。方法:组建研究团队,通过文献循证形成胃癌病人围术期营养管理方案初稿,采用德尔菲函询对15名相关专科领域专家进行专家咨询,进一步修改、完善,形成胃癌病人围术期营养管理方案。结果:共进行2轮专家咨询,2轮咨询专家问卷回收率分别为88.24%和100.00%,2轮专家权威系数分别为0.827和0.833,2轮肯德尔和谐系数分别为0.178和0.180(均P<0.001)。最终形成包含胃癌病人营养管理模式、胃癌病人术前营养干预、胃癌病人术后营养干预、营养支持的监测与护理、出院后营养指导5个一级指标、12个二级指标、31个三级指标的胃癌病人围术期营养管理方案。结论:构建的胃癌病人围术期营养管理方案具有一定的科学性、可靠性、实用性。

肺癌术后肠内营养患者胃潴留影响因素分析

目的探讨肺癌术后肠内营养患者胃潴留的影响因素。方法选取医院2022年1月至2023年11月行手术治疗并配合肠内营养支持的肺癌患者60例,对其胃潴留的发生情况进行监测,分析胃潴留影响因素。结果患者平均置管时间为(12.83±6.22)d。共发生胃潴留5例(8.33%),其中置管10 d内4例,10 d后1例;胃潴留的独立危险因素包括肠鸣音减弱、高血糖、便秘、低血钾、机械通气等。结论肺癌术后肠内营养患者胃潴留的风险较高;独立危险因素包括肠鸣音减弱、高血糖、便秘、低血钾、机械通气等,需针对性开展护理。

胃癌患者术后肠内营养期间引起腹泻的危险因素及干预对策分析

目的 分析胃癌患者术后肠内营养(EN)期间引起腹泻的危险因素及干预对策。方法 回顾性收集2019年6月至2023年6月浙江省丽水市中心医院就诊的216例行胃癌根治术并于术后行EN患者的临床资料。根据腹泻发生情况将其分为腹泻组和未腹泻组,采用单因素和多因素logistic回归分析胃癌患者术后EN期间腹泻发生的影响因素。结果 216例胃癌患者中术后EN期间有141例患者出现腹泻,其发生率为65.28%。两组年龄、手术方式、EN开始时间、营养途径、使用营养泵、术后第1天下床活动时间比较,差异有统计学意义(P<0.05)。年龄≥60岁(OR=3.808,95%CI:2.034~7.129),开腹(OR=4.811,95%CI:1.456~15.904),EN开始时间为术后24 h(OR=5.033,95%CI:1.637~15.473)、未使用营养泵(OR=4.874,95%CI:3.099~7.666)、术后第1天下床活动时间<1 h(OR=2.612,95%CI:1.153~5.914)是胃癌患者术后EN期间腹泻发生的独立危险因素(P<0.05)。结论 胃癌患者术后EN期间腹泻的发生是多种因素影响的结果,临床针对性进行干预有助于预防腹泻的发生。

人文护理联合精准营养干预对进展期胃癌动脉灌注化疗患者负面情绪及胃肠道反应的影响

目的:探讨人文护理联合精准营养干预对进展期胃癌动脉灌注化疗患者的影响。方法:选择2020年3月—2023年1月于贵州医科大学附属白云医院行动脉灌注化疗的46例进展期胃癌患者作为研究对象,按随机数表法将其分为两组,各23例。对照组采取常规干预,观察组采取人文护理联合精准营养干预。比较两组营养风险评估、负面情绪及胃肠道反应发生率。结果:化疗2个周期后,两组营养风险筛查量表(NRS-2002)评分、焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分均低于化疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组各项胃肠道反应发生率均低于对照组,差异有统计学意义(P<0.05)。结论:进展期胃癌动脉灌注化疗患者采取人文护理联合精准营养干预,可明显降低患者营养不良发生风险,改善不良情绪,减轻胃肠道反应。

胃癌术后肠内营养喂养中断患者心理感受的质性研究

目的:了解胃癌术后肠内营养喂养中断患者的心理感受,为临床护士更好地开展肠内营养提供依据和指导。方法:采用现象学质性研究方法,对11例患者进行半结构式深入访谈,并运用Colaizzi 7步分析法对收集的资料进行分析、归纳和总结。结果:经过汇总得出胃癌术后肠内营养喂养中断患者心理负担过重与舒适感双重体验、知识需求迫切、关怀需求强烈3个主题。结论:医护人员需关注肠内营养喂养中断后患者的心理感受,完善宣教系统,提供专业知识的指导,实施人性化的关怀,帮助患者重拾战胜疾病的信心。

早期肠内营养支持对胃癌合并糖尿病患者术后血糖水平、营养状态的效果分析

目的 探讨早期肠内营养支持对胃癌合并糖尿病患者术后血糖水平、营养状态的影响。方法 选取2022年10月-2023年9月泉州市光前医院收治的108例胃癌合并糖尿病患者为研究对象,根据随机数表法分为肠内组和肠外组,各54例。肠外组实施全肠外营养支持,肠内组实施早期肠内营养支持。对比两组患者术前1 d、术后3、7 d的糖代谢指标、营养物质指标及术后7 d的手术切口愈合情况。结果 术后3、7 d,肠内组空腹血糖、餐后2 h血糖水平均低于术前1 d,肠外组各指标水平高于术前1 d,且肠内组各指标水平均低于肠外组,差异有统计学意义(P均<0.05);术后3、7 d,与术前1 d相比,两组血清总蛋白、白蛋白、前白蛋白水平均降低,肠内组各指标水平均高于肠外组,差异有统计学意义(P均<0.05)。术后7 d,肠内组手术切口愈合率高于肠外组,差异有统计学意义(P<0.05)。结论 早期肠内营养支持可提升胃癌合并糖尿病患者术后糖代谢功能、缓解营养物质的流失,提升手术切口愈合速度。

胃癌伴糖尿病患者术后应用肠内营养的护理配合措施的效果分析

目的分析在胃癌伴糖尿病患者术后采取肠内营养的护理配合措施的效果。方法选取2022年1—12月潍坊市中医院收治的60例胃癌伴糖尿病患者为研究对象,按护理措施的不同分成对照组和研究组,各30例。对照组采用常规护理,研究组采用肠内营养的护理配合措施,对比两组患者的血糖指标、营养评分、护理满意度。结果护理后,研究组空腹血糖、糖化血红蛋白水平均低于对照组,研究组营养状况评估量表评分低于对照组,研究组患者的护理满意度高于对照组,差异有统计学意义(P均<0.05)。结论护理配合措施应用于胃癌伴糖尿病患者中,能够维持其稳定的血糖水平,纠正血糖异常指标,保障患者肠内营养支持的合理性与安全性,减轻患者的不适感,为患者争取更为良好的预后。

基于思维导图引导的康复护理结合肠内营养支持对女性胃癌根治术患者心理状态、疼痛程度及营养指标的影响

目的探讨基于思维导图引导的康复护理结合肠内营养支持对女性胃癌根治术患者心理状态、疼痛程度及营养指标的影响。方法选取2021年1月至2023年8月兰陵县人民医院收治的82例女性胃癌根治术患者作为研究对象,按随机数字表法分为对照组与观察组,每组各41例。对照组给予常规护理,观察组给予基于思维导图引导的康复护理结合肠内营养支持。比较两组心理状态、疼痛程度、营养指标及并发症发生情况。结果护理后,观察组焦虑自评量表、抑郁自评量表评分均低于对照组,术后72h的视觉模拟评分法评分低于对照组(P<0.05)。观察组白蛋白、血清总蛋白、前白蛋白、血红蛋白水平均高于对照组(P<0.05)。观察组并发症总发生率为4.88%,低于对照组的19.51%,差异有统计学意义(P<0.05)。结论基于思维导图引导的康复护理结合肠内营养支持可改善女性胃癌根治术患者的心理状态与营养指标,减轻疼痛程度,减少并发症。

早期微生态肠内营养支持联合穴位按摩对腹腔镜胃癌术后患者胃肠功能恢复及营养状况的影响

目的探究早期微生态肠内营养支持联合穴位按摩对腹腔镜胃癌术后患者胃肠功能恢复及营养状况的影响.方法选取2021年3月—2023年3月聊城市东昌府人民医院收治的82例腹腔镜胃癌术后患者为研究对象,按随机数字表法将分为对照组(n=41)和观察组(n=41).对照组采用常规术后干预,观察组在此基础上采用早期微生态肠内营养支持联合穴位按摩.比较两组患者的胃肠功能恢复状况、营养状况、生活质量及并发症发生情况.结果观察组的术后首次排气时间、首次排便时间及肠鸣音恢复时间均短于对照组,组间差异有统计学意义(P<0.05).干预后,观察组的血清总蛋白、白蛋白、前白蛋白水平均高于对照组,组间差异有统计学意义(P<0.05).干预后,观察组的生活质量综合评定问卷中各维度评分均高于对照组,组间差异有统计学意义(P<0.05).观察组的并发症总发生率为7.32%,低于对照组的24.39%,差异有统计学意义(P<0.05).结论早期微生态肠内营养支持联合穴位按摩可促进腹腔镜胃癌术后患者的胃肠功能恢复,改善其营养状况,提高其生活质量.

早期肠内营养与肠外营养在胃癌根治术后应用效果比较

目的：探讨胃癌根治术后分别实施早期肠内营养与肠外营养的临床效果，为胃癌患者术后提供更好的营养支持治疗。方法：回顾性分析本院2009年2月至2011年2月收治的接受胃癌根治术后行肠内营养及肠外营养患者各70例，其中肠外营养组给予常规肠外静脉营养治疗，肠内营养组在术后第1～5天给予肠内营养剂，观察患者术后第1天和第7天血清白蛋白、血红蛋白、丙氨酸转氨酶、天冬氨酸转氨酶水平，及血液中IgA、IgG、IgM和CD4＋细胞、NK细胞、B淋巴细胞情况。结果：肠内营养组术后第1天和第7天血清白蛋白、血红蛋白、丙氨酸转氨酶、天冬氨酸转氨酶水平显著优于肠外营养组，差异有统计学意义（P〈0.05）；同时肠内营养组患者术后第7天与术后第1天及肠外营养组术后第8天比较，IgA、IgG、IgM和CD4＋细胞、NK细胞、B淋巴细胞显著升高，差异有统计学意义（P〈0.05）。结论：胃癌患者术后早期肠内营养可有效改善术后营养水平，以及免疫相关指标，具有临床使用价值。

肠内营养预适应对胃癌术后患者早期肠内营养相关并发症及胃肠功能的影响

目的提高胃癌术后患者早期肠内营养胃肠道耐受性和促进胃肠功能恢复。方法将88例行胃癌根治术后拟早期肠内营养的患者随机分为观察组40例和对照组44例,观察组术前3d开始在常规饮食的基础上口服肠内营养液予以预适应,对照组术前常规饮食。结果观察组术后腹胀、腹泻、腹痛发生率显著低于对照组,首次进食流质时间、首次排气、首次排便时间显著优于对照组(P<0.05,P<0.01)。结论胃癌手术患者术前口服肠内营养能实现胃肠道预适应,能有效降低术后早期肠内营养胃肠道并发症发生率,促进术后胃肠道功能恢复。

术前与术后早期肠内营养对老年胃癌患者术后免疫功能及营养状态的影响

目的:探讨术前1周及术后早期应用肠内营养制剂对老年胃癌患者术后免疫功能及营养状态的影响。方法:选取2011年3月至2014年3月在本院行手术治疗的77例老年胃癌患者,其中38例于术前1周及术后早期给予肠内营养制剂,并标记为实验组;其余39例患者术前1周及术后早期不给予肠内营养支持,并标记为对照组。统计分析两组患者术前、术后第1、8d前白蛋白、白蛋白、转铁蛋白、CD4+T细胞、CD8+T细胞比例、CD4+T细胞/CD8+T细胞(CD4+/CD8+)水平。结果:营养状态方面,术后1d两组患者前白蛋白、白蛋白及转铁蛋白水平均明显下降,且对照组下降程度大于实验组(P<0.05)。免疫功能方面,两组患者CD4+T细胞(%)、CD8+T细胞(%)、CD4+/CD8+水平术后1d均较术前减少,且对照组下降程度大于实验组(P<0.05)。结论:术前1周及术后早期给予老年胃癌患者适当的肠内营养支持,能使患者术后具有更好的免疫功能及营养状况,更有利于患者术后恢复。