鼻肠管早期肠内营养改善老年胃癌术后疲劳综合征的临床研究  

Clinical study on early enteral nutrition with nasal-intestinal tube for improving postoperative fatigue syndrome in the elderly with gastric cancer

作　　者：蒋勇[1] 张义胜[1] 赵国海[1] 

机构地区：[1]皖南医学院弋矶山医院胃肠外科

出　　处：《中国临床药理学与治疗学》2011年第2期203-208,共6页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:观察应用早期肠内营养对老年胃癌患者术后疲劳综合征(POFS)的影响。方法:将80例老年胃癌手术患者随机分为早期肠内营养(early enteral nutrition,EEN)组、肠外营养(par-enteral nutrition,PN)组各40例。EEN组患者,术后24 h开始经鼻肠管予以肠内营养液能全力;PN组患者,术后24 h开始经颈内静脉给予肠外营养。两组患者分别检测氮平衡、疲倦记分、体重、优势手握力、睡眠时间、三头肌皮褶厚度、上臂围、血浆白蛋白、前白蛋白、转铁蛋白以及视黄醛结合蛋白等的变化。结果:术后第7天,EEN组疲劳评分(Christensen记分)明显轻于PN组(P<0.01);EEN组术后第3天转为正氮平衡,PN组术后第6天转为正氮平衡,术后第3天时,两组之间的差异有统计学意义(P<0.01);EEN组累积氮平衡为正氮平衡,PN组累积氮平衡为负氮平衡,两组之间差异有统计学意义(P<0.01);术后第7天,两组病人术后体重、三头肌皮褶厚度及上臂围与术前比较均有下降,但组间无统计学差异(P>0.05),EEN组优势手握力的恢复及睡眠时间的减少均优于PN组(P<0.05);术后第3、7天,EEN组血浆前白蛋白、视黄醛结合蛋白浓度明显高于PN组(P<0.05)。结论:老年胃癌患者术后早期给予肠内营养,能改善病人的疲倦状态,减轻POFS的程度,缩短POFS的持续时间,能改善病人负氮平衡,较快达到正氮平衡,在术后早期更为明显,使病人早日康复。AIM： To study the effects of early enteral nutrition（EEN） with nasal-intestinal tube on the postoperative fatigue syndrome in the elderly with gastric cancer. METHODS： Elder postoperative patients with gastric cancer were randomly divided into EEN group（n=40） and PN group（n=40）.The patients in EEN group were infused with enteral nutritional suspension through nasal-intestinal tube at 24 hours after the operation.The patients in PN group received vein nutrition through the central vein.The indices were investigated such as nitrogen balance,falinue（Chrislensen score）,sleep time,the body weigh,hand grip strength,triceps skin-fold thickness,upper arm circumference,serum levels of albumin,prealbumin,transferring and retinol binding protein.RESULTS：On postoperative day 7,the fatigue scores in EEN group were significantly lower than those in PN group（P0.01）.The positive nitrogen balance in the EEN group was got on the third postoperative day,3 d earlier than that in the PN group,and the levels of nitrogen balance on the third postoperative day were varied significantly between groups（P0.01）.The cumulative nitrogen balance was positive in the EEN group while negative in the PN group（P0.01）.On postoperative day 7,the body weigh,triceps skin-fold thickness,upper arm circumference of the two groups all were dropped but without significant differences（P0.05）,the hand grip strength and sleep time in the EEN group was much superior to the PN group（P0.05）.Serum levels of prealbumin and retinol binding protein in the EEN group were increased more significantly than those in the PN group（P0.01）.CONCLUSION： Early enteral nutrition of gastric cancer in the elderly can improve the POFS,reduce the duration of the POFS,and improve the nitrogen balance,especially during the early postoperative period.

关 键 词：术后疲劳综合征 早期肠内营养 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]