益生菌对胃癌术后早期肠内营养不耐受的预防作用  

Preventive effect of probiotics on early enteral nutrition intolerance after gastric cancer operation

作　　者：王姗[1] 葛思堂 李娟[1] 蔡艳[1] 朱慧秀 WANG Shan;GE Si-tang;LI Juan;CAI Yan;ZHU Hui-xiu(Department of Gastroenterology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院胃肠外科

出　　处：《蚌埠医学院学报》2019年第7期959-962,共4页Journal of Bengbu Medical College

基　　金：蚌埠医学院科技发展基金(BYKY1852,BYKY1784)

摘　　要：目的:观察胃癌病人术后益生菌联合早期肠内营养支持方案对胃肠功能恢复的影响。方法:选取64例接受腹腔镜辅助胃癌根治术的病人,随机分为观察组(n=31)和对照组(n=33)。对照组为单纯早期肠内营养治疗(EEN组),观察组为益生菌联合早期肠内营养治疗(PEEN组)。比较2组病人术前、肠内营养液输注后1d、肠内营养液输注后5d胃肠道功能恢复情况及炎症指标。结果:观察组病人肠内营养胃肠道并发症(腹胀、腹痛、恶心、呕吐等)发生率显著低于对照组(P<0.05);观察组病人首次通气时间、恢复经口饮食时间和术后住院时间均短于对照组(P<0.01);2组病人术前外周血C反应蛋白和白细胞介素-6差异无统计学意义(P>0.05),术后1d和5d外周血C反应蛋白和白细胞介素-6观察组均低于对照组(P<0.05~P<0.01)。结论:益生菌联合早期肠内营养能有效促进胃癌病人术后胃肠功能恢复,降低肠内营养胃肠道不耐受发生率,降低术后应激反应程度,符合加速康复外科理念。Objective: To observe the effects of postoperative probiotics combined with early enteral nutrition support on the recovery of gastrointestinal function in patients with gastric cancer. Methods: Sixty-four patients treated with laparoscopic assisted radical gastrectomy were randomly divided into the observation group( n =31) and control group( n =33).The control group were treated with simple early enteral nutrition group(EEN group),and the observation group were treated with probiotics combined with early enteral nutrition(PEEN group),the recovery of gastrointestinal function and inflammatory marks between two groups were compared before operation,after 1 d and 5 d of the infusion of enteral nutrient solution. Results: The incidence rate of EN gastrointestinal complications(abdominal distension,abdominal pain,nausea,vomiting,etc.) in observation group was significantly lower than that in control group( P <0.05).The first exhaust time,recovery of oral feeding time and postoperative hospital stay in observation group were significantly shorter than that in control group( P <0.01).There was no statistical significance in preoperative C reactive protein and interleukin-6 levels between two groups( P >0.05).The levels of C reactive protein and interleukin-6 in observation group after 1 day of surgery were significantly lower than those in control group ( P < 0.05 to P <0.01). Conclusions: Probiotics combined with early enteral nutrition can effectively promote the recovery of postoperative gastrointestinal function,reduce the incidence rate of enteral nutrition gastrointestinal intolerance and degree of postoperative stress response in patients with gastric cancer,which is in line with the concept of accelerated rehabilitation surgery.

关 键 词：胃肿瘤 益生菌 早期肠内营养 胃肠道功能 护理 

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