糖预处理联合肠内营养对胃癌手术病人的治疗意义  

Significance of preoperative carbohydrate loading and postoperative enteral nutrition in patients with gastric cancer operation

作　　者：李良辉[1] 罗琪[1] 魏黎煜[1] 孟敏君[1] 张颂恩[1] 

机构地区：[1]厦门大学附属中山医院普通外科,福建厦门361004

出　　处：《肠外与肠内营养》2009年第3期141-145,共5页Parenteral & Enteral Nutrition

摘　　要：目的:探讨在围手术期用糖预处理联合EN治疗胃癌病人的临床意义。方法:将胃癌手术病人随机分为三组,即术前常规禁食+术后EN(A组)、术前糖预处理+术后TPN(B组)和术前糖预处理+术后EN(C组)。比较三组病人术后胰岛素敏感性、营养状况、免疫水平和临床恢复的差异。结果:C组病人胰岛素敏感性、营养状况、免疫水平和临床恢复等均优于A组和B组,差异有显著性意义(P<0.05)。结论:术前糖预处理和术后EN具有协同作用,对胃癌手术病人的恢复和预后有着积极的治疗意义。Objective： To explore the clinical significance of combination preoperative carbohydrate loading and postoperative enteral nutrition in patients with gastric cancer during perioperative period. Methods： 70 patients were randomly divided into group A （preoperative fasting ＋ postoperative EN, n = 23 ）, group B （preoperative carbohydrate loading ＋ postoperative TPN, n = 23 ） and group C （preoperative carbohydrate loading ＋ postoperative EN, n = 20） . After operation, insulin sensitivity, nutritional status, immune function and clinical outcome were compared among three groups. Results： Compared with the other two groups in insulin sensitivity, nutritional status, immune function and clinical outcome , the group C was better and different （P 〈 0.05 ）. Conclusion ： Preoperative carbohydrate loading and postoperative EN can improve prognosis of patients following gastic cancer operation.

关 键 词：胃癌 胰岛素抵抗 糖预处理 营养支持 

分 类 号：R735.2[医药卫生—肿瘤] R459.3[医药卫生—临床医学]