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目的:探讨胃癌病人术后给予肠内营养(EN)与肠外营养(PN)在临床应用价值方面的差异。方法:回顾性分析200例胃癌病人术后经EN和PN支持治疗的效果。将胃癌术后病人根据营养支持治疗方式的不同分为EN组(130例)和PN组(70例)。比较两组病人营养支持前、后血红蛋白、红细胞计数、淋巴细胞计数、血清总蛋白、清蛋白、血肌酐、总胆固醇、三酰甘油、血钙、Ig A、Ig G、Ig M水平的变化以及各种并发症发生率、营养支持时间、营养支持平均每天费用及平均住院时间的差异。结果:术后第7天,EN组病人的血红蛋白和红细胞计数明显升高,与PN组比差异有统计学意义(P<0.05)。血清总蛋白、清蛋白和Ig A、Ig G、Ig M水平升高显著,差异有统计学意义(P<0.05);与PN相比,EN组在经7 d营养支持后,白细胞计数、肌酐、总胆固醇、三酰甘油、血钙水平比较均无显著性差异(P>0.05);EN组术后切口感染和肠梗阻发生率均低于PN组,肛门排气时间和术后平均住院时间,平均住院费用均少于PN组。结论:与PN支持比,EN可有效地改善胃癌术后病人的营养状态,提高机体免疫功能。
Objective: To investigate the clinical value of enteral nutrition (EN) and parenteral nutrition (PN) in patients with gastric cancer after operation. Methods: The effect of postoperative EN and PN supportive treatment of 200 gastric cancer patients was retrospectively analyzed. Patients with postoperative gastric cancer were divided into EN group (n = 130) and PN group (n = 70) according to their nutritional support and treatment. The changes of hemoglobin, erythrocyte count, lymphocyte count, serum total protein, albumin, serum creatinine, total cholesterol, triglyceride, serum calcium, Ig A, Ig G and Ig M before and after nutrition support were compared between the two groups The incidence of various complications, nutritional support time, the average daily cost of nutrition support and the average length of stay difference. Results: On the 7th day after operation, the hemoglobin and erythrocyte count of patients in EN group were significantly higher than those in PN group (P <0.05). Serum total protein, albumin and Ig A, Ig G, Ig M levels increased significantly, the difference was statistically significant (P <0.05); compared with PN, EN group after 7 d of nutritional support, white blood cell count, creatinine , Total cholesterol, triglyceride and serum calcium levels were not significantly different (P> 0.05). The incidence of incision infection and intestinal obstruction in EN group were significantly lower than those in PN group, anal exhaust time and postoperative average hospital stay , The average hospitalization costs were less than the PN group. Conclusion: Compared with PN support, EN can effectively improve the nutritional status of postoperative patients with gastric cancer and improve immune function.