胃癌术后早期肠内营养支持的临床观察

目的:观察胃癌术后早期肠内营养支持的临床效果。方法:将76例患者随机分成早期肠内营养(EEN)组和未施行肠内营养(N-EEN)组(n=38),EEN组于胃癌术后24h经术中放置的鼻空肠管应用能全力进行早期肠内营养,N-EEN为术后静脉营养,术前、术后7天测定血清白蛋白、前白蛋白和体重、记录术后肠蠕动、排气时间和术后并发症。结果:两组肠鸣音恢复时间差异无统计学意义,EEN组术后肛门排气时间明显早于N-EEN组(P<0.05);两组术后体重均低于术前,但N-EEN组体重下降更明显,差异有统计学意义(P<0.05);术后第7天,两组患者血清白蛋白、前白蛋白均较术前下降,差异有统计学意义(P<0.05),但两组白蛋白下降的差异无统计学意义,而N-EEN组前清蛋白下降明显,差异有统计学意义(P<0.05)。结论:胃癌术后EEN安全、可靠,具有维护机体代谢平衡、促进肠蠕动的作用,并可减少术后并发症。

Clinical Observation on Early Intraintestinal Nutritional Support of Patients with Carcinomaof Stomach after Operation

Objective:To observe the clinical effects of early post=operative intraintestinal nutritional support in the patients with carcinoma of stomach.Methods:After operation,seventy-six patients with carcinoma of stomach were divided randomly into intraintesti- hal nutrition(IIN)group and non IIN group.The patients in group IIN were given intraintestinal nutrition 24h after operation,and the pa- tients in group N-IIN were given total parenteral nutrition support.The postoperative complications,the recovery time of gurgling sound and exhaust were recorded.The body weight,the levels of albumin and pre-aibumin were tested preoperatively and at postoperative day 7 in all of the cases.Results:The recovery time of exhaust in the patients in IIN group was significantly shorter than that ofN-IIN(P<0.05). The body weight,the levels of pre-albumin at postoperative day 7 was lower than those before operation(P<0.05).Conclusion:Early in- traintestinal nutrition after operation was safe.It can promote an earlier recovery of intestinal movement and improve nutritional status of patients.