早期肠内与肠外营养对进展期胃癌术后患者的支持效果  

Comparison of the effects of early enteral nutrition and parenteral nutrition on patients with advanced gastric carcinoma after operation

作　　者：蔡青山[1] 朴文花[2] 马德强[2] 张恒辉[3] 王炜[2] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏自治区人民医院,宁夏银川750021 [3]北京大学人民医院肝病研究所,北京100044

出　　处：《宁夏医学杂志》2010年第6期501-503,共3页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(N208138)

摘　　要：目的评价早期肠内营养(early enteral nutrition,EEN)与肠外营养(parenteral nutrition,PN)对进展期胃癌术后患者的支持效果。方法将40例进展期胃癌患者随机分为EEN组(n=20)与PN组(n=20)。EEN组患者,术后24h开始经鼻肠营养管予以肠内营养液瑞素;PN组患者,术后24h开始经锁骨下静脉给予肠外营养,两组患者术后营养支持均为7d。两组患者分别于术前1d和术后第8d晨起静脉采血检测营养指标[总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)]和体液免疫指标(IgA、IgM、IgG),并比较两组患者术后肠功能恢复时间(即肛门排气时间)、并发症发生率、营养相关费用等。结果 EEN组患者术后IgA恢复程度显著高于PN组(P<0.05),并且肠功能恢复时间短,并发症发生率及营养相关费用低。结论 EEN是一种安全、有效、经济的营养补给方法 ,而且具有免疫调节作用,所以是进展期胃癌患者术后早期首选的营养支持方法 。Objective To evaluate the effects of early enteral nutrition（EEN）and parenteral nutrition（PN）on patients with advanced gastric carcinoma after operation.Methods Forty patients with advanced gastric carcinoma were randomly divided into EEN group（n=20）and PN group（n=20）.Patients of EEN group received RUISU enteral nutrition by nose-duodenum tube at 24 hours after operation,those of PN group received parenteral nutrition by subclavian vein,nutritional support were all maintained for 7 days.Nutritional indicators such as total protein（TP）,albumin（ALB）,pre-albumin（PA）and humoral immunity parameters（IgG,IgM and IgA）were measured on preoperative 1 day and postoperative 8 days.Meanwhile,the time of passage of gas by anus,incidence rate of complication and nutritional relevant charge were also measured.Results Comparing with PN group,the change of IgA in the EN group was significantly higher（P0.05）,and the time of passage of gas by anus,incidence rate of complication and nutritional relevant charge were significantly decreased in EEN group.Conclusion EEN is a safe,effective and economical method of nutritional supply and includes immunomodulatory effects,so it is a preferred method of nutritional support for patients with advanced gastric carcinoma after operation at prophase.

关 键 词：进展期胃癌 早期肠内营养 肠外营养 免疫调节 

分 类 号：R735.2[医药卫生—肿瘤]