ERAS理念下术前口服糖水对胃癌患者术后快速康复的对照研究  

Rapid Postoperative Recovery in Patients with Gastric Cancer Under ERAS Concept:A Comparative Study

作　　者：舒茂 印义琼[1,2] 汪晓东 刘雨薇[1] Shu Mao;Yin Yiqiong;Wang Xiaodong(Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu,Sichuan 610044;West China Tianfu Hospital,Sichuan University,Chengdu,Sichuan 610044,China)

机构地区：[1]四川大学华西医院胃肠外科,四川成都610041 [2]四川大学华西天府医院,四川成都610041

出　　处：《四川医学》2023年第5期536-539,共4页Sichuan Medical Journal

摘　　要：目的探讨在ERAS理念下,术前口服糖水联合术后部分肠外营养对胃癌患者术后营养状态等快速康复的影响。方法选择2020年1~10月我院胃肠外科收治的胃癌手术患者130例,按照随机数字法分为术前口服糖水联合术后肠外营养组(SPN组)、术后肠内营养联合肠外营养组(EPN组)。SPN组在术前口服糖水,术后1 d实行部分肠外营养支持;EPN组于术后1 d开始肠内联合肠外营养支持。观察两组营养相关指标及身体机能恢复情况。结果同组患者术前1 d、术后1 d和5 d血清总蛋白指标及白蛋白比较,差异均有统计学意义(P<0.05);两组患者术前1 d血清总蛋白和白蛋白指标差异均无统计学意义(P>0.05),术后1 d血清总蛋白、白蛋白指标差异无统计学意义(P>0.05),术后5 d血清总蛋白和白蛋白指标比较,差异有统计学意义(P<0.05),且EPN组>SPN组。两组患者术后开始进食流质时间和下床活动时间比较,差异无统计学意义(P>0.05);术后肛门排气时间、腹腔引流管拔管时间和住院时间指标,差异均有统计学意义(P<0.05),且EPN组>SPN组。结论在ERAS理念下胃癌术前口服糖水对术后营养支持早期康复和缩短住院时间的优势不明显。Objective To study effects of preoperative oral sugar water combined with postoperative partial parenteral nutrition on the postoperative nutritional status and other rapid rehabilitation of patients with gastric cancer under the concept of ERAS.Methods According to random number method,130 patients undergoing gastric cancer surgery at our hospital in 2020 were divided into two groups,including preoperative oral sugar water combined with postoperative parenteral nutrition(SPN),postoperative enteral nutrition combined with parenteral nutrition(EPN).SPN was given sugar water orally before operation,and partial parenteral nutrition support was practiced 1d after operation.However,EPN was given enteral combined parenteral nutrition support starting 1d after operation.Nutrition related indicators were measured and compared before operation,on the 1st and 5th postoperative days.Then,clinically relevant indicators such as time to flatus,time to start feeding and flow,time to the removal of abdominal drainage tube,time to ambulation,and length of hospital stay were further compared.Results In the same group,serum total protein indicators and albumin were compared at 1 d before,1 d and 5 d after surgery(P<0.05).There were no significant differences between the two groups in the serum total protein and albumin indexes measured 1 d before surgery(P>0.05),and in the serum total protein and albumin indexes measured 1 d after surgery(P>0.05).Indexes of serum total protein and albumin were compared 5d after operation with statistically significant difference(P<0.05,EPN>SPN).When compared time between onset of postoperative uid flow and loss of ambulation,there was no signifcant difference(P>0.05).When indicators of postoperative flatus time,extubation time of abdominal drainage tube and hospital stay were compared with statistically significant difference(P<0.05,and SPN<EPN).Conclusion Under ERAS concept,advantages of preoperative oral sugar water in gastric cancer on early rehabilitation and shorter hospital stay after postope

关 键 词：加速康复外科 胃癌 术前口服糖水 肠内联合肠外营养 

分 类 号：R735.2[医药卫生—肿瘤]