血浆胃动素浓度水平与肠内营养耐受性的相关性研究  

Investigation on Tolerance of Enteral Nutrition and Plasma Levels of Motilin in the Patients with Gastric Cancer

作　　者：揭志刚[1] 王小华[1] 楼捷[2] 张青[2] 杨怀成[1] 

机构地区：[1]南昌大学第一附属医院胃肠外科,南昌330006 [2]南昌大学第一附属医院同位素室,南昌330006

出　　处：《实用临床医学（江西）》2007年第1期1-4,共4页Practical Clinical Medicine

基　　金：江西省卫生厅科技计划资助(20045012)

摘　　要：目的:探讨患者对肠内营养(EN)耐受的生物学基础,并为进一步提高肠内营养的质量、降低肠内营养的胃肠道反应提供理论依据。方法:选取40例胃癌患者,平均年龄60.2岁,手术前、后各抽取患者静脉血2 mL,采用放射免疫分析法测定血浆中胃动素(MTL)的浓度,术后24 h开始进行肠内营养;观察患者实行肠内营养后是否出现胃肠道反应,如有则说明对肠内营养不耐受,反之为耐受。结果:患者术后MTL浓度水平较术前有所降低(P<0.05);对肠内营养不耐受的患者,术后MTL浓度水平明显低于耐受者(P<0.05);对肠内营养耐受的患者,手术前后MTL的浓度水平没有统计学意义(P>0.05);对肠内营养不耐受的患者,其年龄比耐受患者大(P<0.05)。结论:患者术后MTL浓度水平与肠内营养耐受性呈正相关,手术后老年患者对EN的耐受性比青年患者差,对于术后老年患者使用EN时应加以选择。Objective： To reveal the biologic base for the tolerance of Enteral Nutrition and provide the theoretical base to improve the quality of Enteral Nutrition and cut down the response of the gastrointestinal tract. Methods： Forty patients with gastric cancer were collected, the mean-age was 60.2Y. 2 mLVB（venous blood） were drawn before and after operation and the concentration of the MTL in plasma was measured through Radio Immunoassay（RIA）;The Enteral Nutrition was undertook on the 24 hours after the operation and the responses of the gastrointestinal tract were observed during it. The patients who had the responses was intolerance to the Enteral Nutrition, on the contrary, was tolerance to the Enteral Nutrition. Results：The concentration of MTL in preoperation and postoperation, was statistical different（P〈0. 05）; For the intolerant patients,the mean concentration of MTL in postoperation was obviously lower than that of preoperation（P〈0.05）, but there wasn＇t difference in the tolerant group（P〉0.05） ;The mean-ge of the tolerant patients was higher than that in intolerative patients（P〈0.05）. Conclusion：The concentration of MTL of postoperation patient is positively correlated with the tolerance of enteral nutrition. The tolerance of EN of the old patients is worse than youth, so using EN on postoperation old patients should be selected.

关 键 词：肠内营养 耐受 血浆胃动素 胃肿瘤 

分 类 号：R735.2[医药卫生—肿瘤]