胃癌术后早期整蛋白复方制剂肠内营养治疗的临床对照研究  

Postoperative early enteral nutrition therapy with long peptide mixture for gastric cancer patients:a clinical control study

作　　者：蒲江[1] 纪伟平 龙菲[1] 黄金凤[1] 高帆[1] 陈剑伟[1] 毕建威[2] 蔡全才[3] 

机构地区：[1]第二军医大学长海医院科研科,上海200433 [2]第二军医大学长海医院普外科,上海200433 [3]第二军医大学长海医院流行病与循证医学中心,上海200433

出　　处：《第二军医大学学报》2014年第3期256-259,共4页Academic Journal of Second Military Medical University

基　　金：第二军医大学长海医院"1255计划"项目(CH125530600);复旦大学医院管理研究所慢病管理科研项目(FDCDM201307)~~

摘　　要：目的对比研究胃癌患者予远端胃大部分切除术后早期行整蛋白复方制剂肠内营养(EN)的效果。方法将70例胃癌行远端胃大部分切除术后患者随机分为2组(n=35),一组术后早期给予整蛋白复方制剂肠内营养作为试验组(NEN组),另一组术后早期给予葡萄糖盐水肠内营养作为对照组(GEN组)。结果两组患者经治疗后,术后肠蠕动恢复时间、通气时间等差异无统计学意义;消化道症状比较,NEN组的腹泻、呕吐较GEN组明显(P=0.048,P=0.000);住院时间和总住院费用比较两组间差异无统计学意义;营养参数方面,NEN组的前白蛋白在术后第4天、第7天均明显高于GEN组(P=0.000,P=0.000);免疫指标比较,NEN组的IgG在术后第4天、第7天均明显高于GEN组(P=0.000 6,P=0.000 8),IgM在术后第7天明显高于GEN组(P=0.0001)。结论胃癌行远端胃大部分切除术后行早期整蛋白复方制剂肠内营养治疗会有较明显的消化道刺激症状,但不会明显增加患者的住院时间和费用,可较快改善患者术后的营养和机体免疫状态。Objective To study the efficacy of postoperative early enteral nutrition(EN)therapy with long peptide mixture in gastric cancer patients receiving distal subtotal gastrectomy.Methods A total of 70patients with gastric cancer were randomly divided into experimental group(n=35)and control group(n=35)after distal subtotal gastrectomy.The experimental group received early enteral nutrition with long peptide mixture postoperatively(NEN group)and the control group received early enteral nutrition with glucose saline postoperatively(GEN group).Results There were no significant differences in the recovery time of intestinal peristalsis or ventilation time between the two groups after treatment.Significant differences were found between the two groups regarding the symptoms of diarrhea and vomiting(P=0.048,P=0.000).The hospitalization time and total cost of hospitalization were not significantly different between the two groups.The level of prealbumin in the experimental group was significantly higher than those in the control group on the fourth and seventh days after operation(P=0.000,P=0.000);moreover,compared with the control group,the experimental group had significantly higher IgGlevel on the fourth day and seventh day after operation(P=0.000 6,P=0.000 8),and IgM level was significantly higher than that in the control group on the seventh day after operation(P=0.000 1).Conclusion Postoperative early enteral nutrition with long peptide mixture can induce obvious gastrointestinal irritation symptoms in gastric cancer patients receiving distal subtotal gastrectomy,but it does not greatly increase the hospitalization time or cost,and can rapidly improve the nutrition and immune state of patients.

关 键 词：胃肿瘤 胃切除术 整蛋白复方制剂 肠道营养 手术后医护 

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