胃癌术后早期的肠内营养支持  

Early Enteral Nutrition Supports in Postoperative Patients with Gastric Carcinoma

作　　者：郝文立 周振理[2] 陈鄢津[2] 马军宏[3] 

机构地区：[1]天津市中医药研究院附属医院外科,天津300120 [2]天津市南开医院第一外科 [3]天津中医药大学

出　　处：《中国中西医结合外科杂志》2007年第4期345-347,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:观察胃癌术后患者早期给予肠内营养(EN)支持治疗的临床疗效。方法:肠外营养支持(PN)组术后每日行完全肠外营养支持直到经口进食。EN组术后第1d以静脉支持为主,第2d开始经空肠造瘘管滴入肠内营养制剂能全力,逐步加大支持强度并减少静脉支持。观察术后排气排便时间、并发症发生率、体重、血红蛋白(HGB)、血浆前白蛋白(PALB)和外周血淋巴细胞计数(LY)。结果:EN组术后排气、排便时间和术后平均住院时间均短于PN组。术后第7dEN组各项指标的恢复速度均优于PN组。EN组术后并发症发生率为27·3%(3/11),明显低于PN组54·6%(6/11)。结论:胃癌术后早期EN支持可促进小肠运动功能恢复,加快免疫和营养状态改善,降低了并发症的发生率。Objective To investigate the clinical therapeutic effect on early enteral nutrition supports in postoperative patients with gastric carcnoma Methods Patients with gastric carcinoma were divided into 2 groups postoperatively. Those of parenteral nutrition （PN） group were given total parenteral nutritional supports as routinely started from the 1^st postoperative day until oral feeding. Patients of the enteral nutrition（EN） group were given parenteral nutritional supports routinely on the 1^st day, then with all strength to drip in nutrition fibre through the jejunal fistula beginning from the second postoperative day, to strengthen the intensity of support and to reduce the venous support gradually. The observation indices included the flatus passing and defecation time, morbidity, body weight changes, hemoglobin level, plasma albumin level and peripheral blood lymphocyte count. Results The time of breaking wind and of bowel movement, and of hospital stay after operation in the EN group was shorter than that of the PN group. In the first seven days after surgery, various parameter recovery rates in group EN were better than those in group PN. The postoperative complication rate of group EN was 27.3 %, significantly lower than that in PN （54.6 % ）. Conclusion Early postoperative enteral nutrition support can promote the recovery of intestinal motor function, improve the nutritional status and immunity and reduce the incidence of complications.

关 键 词：胃癌 肠内营养 肠外营养 

分 类 号：R459.3[医药卫生—治疗学]