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目的研究分析早期肠内营养对于胃癌行全胃切除术患者的意义。方法将37例胃癌行全胃切除的患者,分为早期肠内营养组(EN组,n=18)及完全肠外营养组(PN组,n=19)进行对比。EN组在术后1～2d均通过复尔凯空肠营养管输注肠内营养液;PN组通过中心静脉给予静脉营养。2组按热量30kcal.kg-1.d-1,氮量为0.12g.kg-1.d-1给予营养。结果①EN组营养住院费用少于PN组(P<0.01);EN组肛门排气时间少于PN组(P<0.01);EN组住院天数少于PN组,但无统计学差异;②术后7d:EN组营养指标均高于PN组,但2组间比较没有统计学差异;③术后7d:EN组免疫指标均高于PN组,2组间比较IgM有显著性差异(P<0.05);而IgA比较有高度显著性差异(P<0.01)。结论与PN支持相比较,EN可促进肠功能的恢复,降低住院费用,有效地改善全胃切除患者的免疫状态及改善营养状态。
Objective To study the significance of early enteral nutrition in patients undergoing total gastrectomy for gastric cancer. Methods 37 patients with total gastrectomy for gastric cancer were divided into two groups: early enteral nutrition group (EN group, n = 18) and complete parenteral nutrition group (PN group, n = 19). The enteral nutrition solution was infused in EN group 1 ~ 2 days after operation through Falkai jejunal feeding tube. The PN group received intravenous nutrition through the central vein. 2 groups according to heat 30kcal.kg-1.d-1, nitrogen is 0.12g.kg-1.d-1 to give nutrition. Results ① The hospitalization expenses of EN group were less than those of PN group (P <0.01); the time of anal exhaust in EN group was less than that of PN group (P <0.01); The hospitalization days of EN group were less than those of PN group 7d: The nutritional indexes of EN group were higher than that of PN group, but there was no significant difference between the two groups. (3) The immunological indexes of EN group were higher than those of PN group after 7 days of operation. There was significant difference between the two groups (P <0.05) ); While IgA had a highly significant difference (P <0.01). Conclusions Compared with PN support, EN can promote the recovery of intestinal function, reduce the cost of hospitalization, effectively improve the gastrectomy patients immune status and improve nutritional status.