胃癌术后肠内营养应用方法及耐受性分析  

Application and tolerance analysis of postoperative enteral nutrition in patients with gastric cancer

作　　者：侯钦猛[1] 丁连安[1] 牛冬光[1] 曲国建 刘路光[1] 

机构地区：[1]青岛大学医学院附属医院东区普外科,266000 [2]青岛市商业职工医院普外科

出　　处：《中华临床营养杂志》2014年第2期97-100,共4页Chinese Journal of Clinical Nutrition

摘　　要：目的探讨胃癌术后肠内营养（EN）耐受性影响因素及EN具体实施方法。方法选取2011年11月至2012年9月在青岛大学医学院附属医院普外科行胃癌手术的患者54例为研究对象，以序贯、渐进的方法实施EN，观察EN耐受情况，对患者EN耐受性进行单因素和多因素Logistic回归分析，记录患者EN期间的消化道症状。结果54例患者中，49例（90．74％）能耐受EN。肿瘤分期（单因素分析：X2=7．287，P=0．007；多因素分析：t=2．559，P=0．014）、手术方式（单因素分析：X2=7．825，P=0．005；多因素分析：t=2．254，P=0．043）是影响EN耐受性的因素。在耐受患者中，EN期间胃肠道症状以腹胀为主（19／49，38．8％）。结论序贯、渐进的EN方法适合胃癌术后患者，可在临床推广应用。Objective To explore the factors related to the tolerance to enteral nutrition （EN） in gastric carcinoma patients undergoing surgical treatment and the implementation strategy of EN. Methods Fifty-four patients with gastric carcinoma undergoing surgery from November 2011 to September 2012 in the Affiliated Hospital of Medical College of Qingdao University were enrolled. EN were applied with sequential and gradual strategies. The tolerance status to EN was recorded. Factors related to the patient tolerance to EN were analyzed using single-factor and multiple-factor Logistic regression analysis. The incidences of gastrointestinal symptoms during EN application were recorded. Results Among the 54 patients, 49 （90. 74% ） patients could tolerate EN. Single-factor analysis and multiple-factor Logistic regression analysis both showed that tumor staging （ single-factor analysis ： X2 = 7. 287, P = 0. 007 ; multiple-factor analysis ： t = 2. 559, P = 0. 014） and surgical approach （ single factor analysis ：x2 = 7. 825, P = 0. 005 ; multiple-factor analysis ： t = 2. 254, P = 0. 043 ） were major factors affecting patient tolerance to EN. Among the patients tolerant to EN, abdominal distension （ 19/49, 38. 8% ） was the major gastrointestinal symptom of EN. Conclusion The sequential and gradual EN application strategy is suitable for the patients with gastric cancinoma after surgery, and can be widely used in clinical practice.

关 键 词：胃肿瘤 肠内营养 耐受性 

分 类 号：R735.2[医药卫生—肿瘤]