老年胃肠道恶性肿瘤术后早期肠内-肠外营养联合应用的作用  

Parenteral Nutrition(PN) Combined with Enteral Nutrition(EN) in Gastric and Intestinal Malignant Tumor in Elderly

作　　者：林坚[1] 王鸣[1] 余琪[1] 刘有英[1] 彭炜[1] 舒志军[1] 

机构地区：[1]上海市中西医结合医院普外科,上海200082

出　　处：《临床急诊杂志》2008年第1期22-23,27,共3页Journal of Clinical Emergency

摘　　要：目的探讨老年胃肠道恶性肿瘤术后早期肠内营养和肠外营养联合应用的可行性、安全性和临床效果。方法 60例胃肠道恶性肿瘤根治性手术的老年患者,术后第1天随机分为(1)肠外营养(PN)组;(2)肠内和肠外联合营养(EN-PN)组;(3)对照组。观察在治疗过程中3组患者并发症的发生率,术后胃肠功能恢复时间及营养评定的各项指标并进行对比分析。结果对照组并发症发生率明显高于 EN-PN 组和PN组(P<0.05)。对照组术后胃肠功能恢复时间较 EN-PN 组和 PN 组明显延长。而 EN-PN 组较其它两组显著缩短(P<0.05)。EN-PN 组和 PN 组术后血清蛋白、前白蛋白、转铁蛋白和淋巴细胞总数在营养支持后均明显升高(P<0.05),体重下降缓慢。结论胃肠道恶生肿瘤根治术后早期肠内营养及肠外营养联合应用安全可行。在改善机体营养状况方面与肠外营养相似,并有促进和维护胃肠道功能的作用,且费用较低。Objective To investigate the feasbility,security and clinical effect ofparenteral nutrition（PN） combined with enteral nutrition（EN） in gastric or intestional malignant tumor in elderly. Methods 60 cases of senile gastric or intestinal malignant tumor were collected, and randomized divided into three groups that were PN group, PN-EN group, and control group. Complications, time of gastro-intestinal function recovery, and nutritional evaluation were analyzed. Results Control group has more complications than other two groups, while the time of gastro - intestinal function recovery was also longer than the other two. PN-EN group spent less time in gastro - intestinal function recovery than other two groups ,and it also raised the level of Albumin, Proalbumin, Haptoglobin Tansferin Hemoglobin and the number of lymphocyte. Less weight was lost in PN-EN group. Conclusion In senile gastric and intestinal malignant tumor, parental nutrition （PN） combine with enteral nutrition （EN） is safe. It costs less and can accerate the recovery, of gastro-intestinal function, and has the function like TPN in improve nutritional status.

关 键 词：胃肠道恶性肿瘤 早期肠内营养 肠外营养 

分 类 号：R735[医药卫生—肿瘤]