胃癌及结肠癌术后早期肠内营养的临床应用  

Clinical complication understanding of early postoperative enteral nutrition in gastrocolonic surgery

作　　者：李锋[1] 贺进军[1] 赵瑛[2] 

机构地区：[1]山西省吕梁市人民医院普外科,033000 [2]山西医科大学第一医院普外科

出　　处：《肿瘤研究与临床》2007年第6期395-396,399,共3页Cancer Research and Clinic

摘　　要：目的评价肠内营养(EN)对胃癌、结肠癌术后免疫功能及炎症反应的影响。方法将58例行胃、结肠癌根治术后患者随机分为EN组和完全胃肠外营养(TPN)组,EN组于术后24 h开始将肠内营养混悬液(商品名:能全力)经鼻肠管滴入至患者能进流食。TPN组于术后进行TPN,肠蠕动完全恢复后开始进食。分别于术前第1天,术后第3、8天检测外周血IgA、IgG、IgM、C3、C4、CRP、淋巴细胞计数(LYM)、淋巴细胞(LYM)百分比、总蛋白(TP)、清蛋白(ALB)、前清蛋白(PA)。结果术后第8天较术后第3天(除CRP外)EN组上述指标回升幅度[(0.926±0.468)g/L、(6.011±3.179)g/L、(0.754±0.465)g/L、(1.178±0.581)×10~9/L、(18.685±14.331)%、(63.875±32.436)mg/L]高于PN组[(0.081±0.527)g/L、(0.440±3.363)g/L、(0.093±0.449)g/L、(0.293±0.176)×10~9/L、(4.443±5.724)%、(34.571±31.701)mg/L],差异有统计学意义(P【0.05);EN组CRP明显降低,对照组未降低,两组差异有统计学意义(P【0.05)。结论胃、结肠癌患者术后早期接受EN较TPN支持能较好地提高患者免疫功能,降低炎症反应。Objective To evaluate if the enteral nutrition have effect on the immune function and in- flammatory reaction after operating about gastric carcinoma.Methods 58 postoperative patients suffering from stomach cancer and colon cancer were randomly divided into the EN group and the TPN group.On the first postoperative day,nutrition fibre were given via nasal intestinal tube,increasing the capacity and drop- ping speed day by day until patients can eat liquid diet.While patients in the TPN group didn't eat anything until enterokinesia completely recovered.Observing on preoperative day 1 and on postoperative day 3 and day 8 respectively to check IgA,IgG,IgM,C3,C4,CRP,LYM,LYM%,TP,ALB,PA.Results The results showed that on the postoperative day 8,the target ascension extent was higher than that in the PN group.The statistical significance was very obvious(P<0.05),at the same time the CRP in EN group decreased remark- ably while that in TPN didn't,the difference was very obvious(P<0.05).Conclusion The patients suffering from stomach cancer and colon cancer who accepted EN in advance is better than those who accepted TPN in improving the immune function and decreasing inflammation reaction.

关 键 词：肠道营养 胃肿瘤 结肠肿瘤 

分 类 号：R735[医药卫生—肿瘤]