不同营养方式在胃癌根治术后的应用

Comparison of Different Nutrition Support Therapy in Patients with Radical Gastrectomy

关键词:  胃癌根治术  肠内营养  肠外营养

Key words:  radical gastrectomy  enteral nutration  parenteral nutration

摘要:

目的 探讨胃癌根治术后，全肠外营养(total parenteral nutrition，TPN)、肠外营养(parenteral nutrition，PN)联合肠内营养(enteral nutrition，EN)对患者营养状况的改善以及并发症发生率的影响。方法 接受胃癌根治术的患者58例，随机分成TPN组和PN+EN组，各29例。2组患者手术后第1天开始分别给予肠外营养或者肠内营养支持。于手术前1 d和手术后第8天检测体质量、白蛋白、血红蛋白、白细胞、肛门排气时间、住院时间等指标。结果 2组患者术后体质量、白蛋白、血红蛋白、白细胞住院时间比较无显著性差异。PN+EN组术后肠道功能恢复时间明显少于TPN组(P<0.05)，感染发生率少于TPN组(P<0.05)。结论 2组营养支持均可改善胃癌根治术患者的营养状态，但是，EN与PN相比，对患者肠道的康复和减少感染发生率有好处。

Abstract:

OBJECTIVE To observe the effect of total parenteral nutrition(TPN) and parenteral nutrition(PN) combined with enteral nutritional(EN) supports on postoperative nutrition and the incidence of complications of patients with radical gastrectomy. METHODS The 58 cases of patients with radical gastrectomy divided into TPN group and PN+EN group(n=29). Each group were given enteral or parenteral combined with enteral nutrational support began at the first day after operation. Body weight, ALB, Hb, WBC between preoperation and postoperattion, the anal exsufflation time, infectious complication rate and duration of hospital stay were measured. RESULTS There was no significant difference between the two groups on postoperative body weight, ALB, Hb, WBC and duration of hospital stay. The anal exsuffation time was significantly longer and infectious complication rate was higher in TPN group than PN+EN group(P<0.05). CONCLUSION The two nutritional support methods can both improve the nutritional status. EN can reduce the incidence of infection of patients and improve intestinal recovery in patients with radical gastrectomy.