早期肠内营养在胃癌术后应用的疗效观察  

The clinical observation of early enteral nutrition in patients with postoperative stomach carcinoma

作　　者：伍剑斌[1] 曾兵[2] 柳霞[1] 

机构地区：[1]广州市中医医院,510130 [2]广州中医药大学,510405

出　　处：《广州医药》2009年第5期8-11,共4页Guangzhou Medical Journal

摘　　要：目的观察胃癌患者术后早期应用肠内营养支持(EEN)的临床疗效。方法将71例胃癌患者随机分为肠内营养组(EEN)和肠外营养组(PN组),于术后24小时开始分别给予肠内营养和肠外营养支持;检测两组患者术前1天及术后第1天、术后第8天白蛋白(ALB)、前白蛋白(PA)、免疫球蛋白和T淋巴细胞亚群的水平;观察两组患者术后肠功能恢复时间、术后并发症及平均住院费等。结果所有患者在研究期间无死亡。营养支持结束时EEN组PA、IgG、IgA、CD3+、CD4+及CD4+/CD8+比值明显高于PN组(P<0.01),而胃肠道功能恢复时间、并发症和平均住院费用明显低于PN组(P<0.01);两组患者ALB、IgM、CD8+及体质量在营养支持结束时比较无显著差异(P>0.05)。结论胃癌患者术后早期应用肠内营养支持安全可行,能有效地改善患者术后营养状况和免疫功能,加快术后胃肠道功能恢复,减少术后并发症,缩短住院时间和节省医疗费用。Objective To observe the effect of early enteral nutrition in patients with postoperative stomach carcinoma. Methods 71 cases of postoperative patients of stomach carcinoma were randomly divided into two groups. One group was given parenteral nutrition （PN group） and the other group was fed with enteral nutrition （EEN group） after 24 hours of the operation. Some variables were measured before operation and on postoperative day 1 and 8. Such as albumin, prealbumin. T-lymphocyte subsets, time of restoration of gastrointestinal function, postoperative complications, cost and length of hospital stay were also evaluated. Results No mortality occurred in all patients during the period of study. After the study, the levels of Prealbumin, IgG, IgA, CD3^＋ , CD4^＋and CIM ＋/CD8^＋ ratio in the EEN group were significantly higher than the levels in the PN group. The recovery time of gastrointestinal function, the postoperative complications and the average cost of hospital stay in the EEN group were significantly lower than those in the PN group. Conclusion Early enteral nutrition in patients with postoperative stomach carcinoma is safe, and has obvious advantages in enhancing the body status of nutrition and immune function, promoting the restoration of gastrointestinal function, and reducing the postoperative complications, the cost and length of hospital stay.

关 键 词：胃癌 早期肠内营养 肠外营养 

分 类 号：R735.2[医药卫生—肿瘤]