胃癌患者全胃切除术后家庭肠内营养可行性研究  

Study on the feasibility of enteral nutrition after total gastrectomy for gastric cancer 4 weeks home

作　　者：张明[1] 朱信强[1] 丁闯[1] 孔令永[1] 陈焰[1] 

机构地区：[1]南京鼓楼医院集团宿迁市人民医院普外科,江苏宿迁223800

出　　处：《中国肿瘤外科杂志》2017年第2期113-116,共4页Chinese Journal of Surgical Oncology

摘　　要：目的探讨胃癌全胃切除术后日常家庭肠内营养的可行性。方法将南京鼓楼医院集团宿迁市人民医院2013年2月至2015年10月收治的40例全胃切除术患者,按抽签分组法分为试验组20例(患者出院后仍保留鼻空肠营养管4周)和对照组20例(患者出院时即拔除鼻空肠营养管)。观察患者出院后4周的营养摄入量、营养参数、生活质量和医疗费用。结果出院后4周,对照组患者体重下降较试验组更多,试验组患者右手握力大于对照组,且血浆总蛋白、血红蛋白含量高于对照组,差异有统计学意义(均P<0.05);两组上臂肌围、血浆白蛋白相比,差异无统计学意义(均P>0.05)。EORTC QLQ-C30生活质量量表评分显示,试验组的整体健康状态、情绪功能优于对照组,症状量表中试验组患者恶心呕吐及疲劳症状均小于对照组(均P<0.05);但在腹泻及医疗费用中,试验组高于对照组(均P<0.05);两组患者躯体功能、睡眠障碍相比,差异无统计学意义(P>0.05)。结论胃癌患者全胃切除术后实施家庭肠内营养不仅能改善营养状况、提高生活质量,而且安全简便,不良反应发生率低,安全可行。Objective To evaluate the feasibility of daily home enteral nutrition after total gastrectomy. Methods A total of 40 patients underwent total gastrectomy in the Nanjing Drum-tower Hospital group in Suqian People＇s Hospital from February 2013 to October 2015 were divided into the experimental group（20 patients were remained nasojejunal feeding tube for 4 weeks after discharge） and the control group（20 patients were removed nasojejunal feeding tube after discharge） according to the sortition randomization method. Main outcome measured nutritional intake, nutritional parameters, quality of life, and health care costs. Results After 4 weeks, compared with the two groups of nutrition indicators, the patients in the control group decreased more weight than in the experimental group. The right hand grip, total protein, and hemoglobin content in the experimental group were higher than those in the control group, the differences were statistically significant （ all P 〈 0. 05 ）. There were no statistically significant differences between two groups in upper arm muscle circumference and albumin（P 〉 0.05 ）. EORTC QLQ-C30 quality of life score showed that the experimental group＇s overall health status and emotional function were better than those of the control group. The symptom scale showed that nausea and vomiting and fatigue symptoms in the experimental group were less than those in the control group（P 〈 0. 05） ; but the diarrhea and medical expenditure in the experimental group were higher than those in the control group（P 〈 0.05）. There were no statistically significant differences in physical function, sleep disorders between the two groups （ P 〉 0. 05 ）. Conclusion Home enteral nutrition tube can improve the nutritional status and quality of life for patients who underwent total gastrectomy. It is safe, easy used and feasible, with low inci- dence of adverse reactions.

关 键 词：胃肿瘤 胃切除术 生活质量 问卷调查 肠内营养 

分 类 号：R735.2[医药卫生—肿瘤]