胃癌术后早期肠内营养对肠黏膜通透性的影响  

Influence of Early Stage Enteral Nutrition on Permeability of Enteric Mucosa in Postoperative Patients of Gastric Carcinoma

作　　者：叶向红[1] 彭南海[1] 

机构地区：[1]中国人民解放军南京军区南京总医院,210002

出　　处：《护理研究》2003年第10A期1148-1150,共3页Chinese Nursing Research

摘　　要：目的 :了解胃癌术后早期肠内营养 (EN )和肠外营养(PN)对病人肠黏膜通透性的影响。方法 :选取胃癌病人 40例 ,随机分为两组 ,实验组 (EN组 )术中置空肠造口管 ,术后 3d～ 11d给予肠内营养支持 ,术后第 3天给予全量的 1/4 ,第 4天给予全量的 1/2 ,第 5天～第 11天给全量。对照组 (PN组 )术后第 3天～第 11天给予肠外营养支持 ,即常规方法输液。结果 :肠内营养组术后第7天其肠黏膜通透性虽然较术前有明显升高 ,但明显低于肠外营养组 ,对照组前白蛋白术后第 7天较术前有明显下降(P <0 .0 5 ) ,术后第 12天较术后第 7天有明显上升 (P <0 .0 1) ;实验组术后第 7天、第12天前白蛋白 (PA)、纤维连接蛋白 (FN)均明显高于对照组。术后肠通气时间 :对照组 96.0h± 8.3h ,实验组 84.0h± 7.5h。结论 :术后早期肠内营养在维护肠黏膜屏障功能。Objective: to find out the Influence of early stage enteral nutrition (EN) and parenteral nutrition (PN) on the permeability of enteric mucosa in postoperative gastric carcinoma patients. Methods: a total of 40 cases gastric carcinoma were selected and divided into two groups randomly. Patients of test group were performed jejunostomy and put a tube inside during the operation. They were given enteral nutritional supports 3 days to 11 days after their surgery. Patients of control group were got parenteral nutritional supports as routinely started on the 3rd day until 11 days after the operation. Results: patients of test group had a higher permeability of enteric mucosa after their surgery than that of before their operation. But the enteric mucosa permeability of test group postoperative patients was lower than that of control group patients. Blood prealbumin concentration of control group patients on the 7th day of post-operation decreased remarkably than that of pre-operation (P<0.05). It was elevated on the 12th days after the operation compared with that of the 7th post-operation day (P<0.01). Both blood prealbumin and fibronectin (FN) concentration of test group patients on the 7th and 12th post-operation day were remarkably higher than that of control group patients on the same post-operation day respectively. The post-surgical enteric exsufflation time in patients of test and control group were 84.0 h±7.5 h and 96.0 h±8.3 h respectively. Conclusion: in terms of both maintenance of barrier function of enteric mucosa and the improvement of nitrogen balance, patients got early stage post-operative enteric nutrition were superior to those who just got parenteral nutrition.

关 键 词：胃癌 肠内营养 肠外营养 肠黏膜通透性 

分 类 号：R473.73[医药卫生—护理学]