胃癌患者术后肠内营养支持时机探讨  

Discussion on timing of enteral nutrition support in postoperative patients with gastric cancer

作　　者：李倩[1] 韩丁[1] 姚俊英[1] 范旻[1] LI Qian HAN Ding YAO Junying FAN Min(Institute of Clinical Nutrition, The Xinjiang Uygur Autonomous Region People＇s Hospital, Urumqi 830000, Chin)

机构地区：[1]新疆维吾尔自治区人民医院临床营养研究所,乌鲁木齐830000

出　　处：《新疆医科大学学报》2016年第11期1386-1388,共3页Journal of Xinjiang Medical University

基　　金：十二五科技支撑计划(2012BA135B03)

摘　　要：目的探讨胃癌患者术后应用早期肠内营养支持的恰当时机。方法选择行胃癌根治手术治疗的患者150例,随机分成A、B、C组3组,每组50例,分别于手术后12 h开始肠外营养(PN)支持,术后24、36、48 h给予肠内营养(EN)支持,其中A组、B组为试验组,C组为对照组。比较3组患者术后的营养恢复状况及肠蠕动恢复、肛门排气、排便时间及并发症的发生情况。结果手术后2 w BMI较术前变化不大,TSF、PA、ALB、HB、TLC有明显改善,与术前1周相比,差异有统计学意义(P<0.05),与C组相比,A组、B组术后肠蠕动恢复时间缩短,肛门排气时间提前(P<0.05),A组和B组腹泻人数明显增加(P<0.05),3组吻合口瘘及切口感染发生率差异无统计学意义(P>0.05)。结论胃癌术后12 h可以行早期肠内肠外营养支持,但是过早肠内营养支持腹痛、腹胀等不良反应发生率高,视病情推后肠内营养支持时间,更利于术后肠道功能的恢复。Objective To explore the appropriate time of postoperative early enteral nutrition support for gastric cancer patients. Methods 150 cases of gastric cancer radical surgery patients were randoely divided into A,B,group C 3 groups,50 cases in each group,respectively. Parenteral nutrition（ PN） support was initiated at 12 h postoperatively,then the patients in group A,group B and group C were given the enteral nutrition（ EN） support after 24,36 and 48 h postoperatively,respectively. Group A and group B are the experimental groups,while group C was the control group. The nutritional status and recovery of peristalsis,anal exhaust,defecation time and complication were compared among the three groups. Results Compared with group C,the recovery time of peristalsis in group A and B was shortened and the duration of anal exhaust was shortened,but the incidence of abdominal pain was increased in group A and B（ P〈 0. 05）（ P 〉0. 05）. The incidence of anastomotic fistula and wound infection was not statistically significant（ P〉 0. 05）. Conclusion The early enteral parenteral nutrition support can be implemented at 12 h after resection of gastric cancer,,but too early enteral nutrition may raise the incidence of abdominal pain,abdominal distension and other adverse reactions Depending on the condition,postponing the enteral nutrition support time is more conducive to the recovery of postoperative intestinal function.

关 键 词：胃癌 肠内营养 肠外营养 

分 类 号：R735.2[医药卫生—肿瘤]