胃癌行全胃切除术后早期肠内营养应用.docVIP

胃癌行全胃切除术后早期肠内营养应用 　　【摘要】 目的 研究早期肠内营养在胃癌行全胃切除术患者中的作用。方法 分析48例胃癌行全胃切除术患者,分为早期肠内营养(EEN组,n=24)及完全肠外营养(TPN组,n=24)。EEN组在术后1~2 d均通过空肠营养管输注能全力(纽迪西亚产品);TPN组通过中心静脉给予静脉营养。两组予等热量、等氮量,总热量30 kcal/(kg#8226;d),氮量为0.2 g/(kg#8226;d)。结果 ①EEN组肛门排气时间少于TPN组(P0.01),EEN组术后住院天数少于TPN组(P0.05);②术后7、10 d:EEN组体各指标均高于TPN组,两组间比较转铁蛋白有显著性差异(P0.05);而前白蛋白比较有高度显著性差异(P0.01)。结论 与TPN支持相对比,EEN可促进肠功能的恢复,缩短住院时间,有效地改善全胃切除患者的营养状态。 　　【关键词】胃癌;全胃切除;肠内营养;肠外营养 　　 　　The application ofearly enteral nutrition after total gastrectomy 　　 　　CHEN Wei-wen,YAO Zhi-xun.The People’s Hospital of Chaoyang Distric,Shantou 515100,China 　　 　　【Abstract】 Objective To study the effect of early enteral nutrition after total gastrectomy.Methods 48 cases of postoperative patients of gastric cancer after totalgastrectomy were randomly divided into two groups,early enteral nutrition group(EEN group,n=24)and total par-enteral nutrition group(TPN group,n=24).The patients in EEN group were infused Enteral Nutritional Suspension(Nutricia Corp.)through jejunum atpostoperative day 1 or day 2; The patients in TPN group received vein nutrition through the central vein.Each patient in the two groups received same calory,30kcal/kg#8226;d,and same nitrogen,0.2 g/(kg#8226;d).Results EEN group was earlier in the time of anus exhaust than TPN group(P0.01)and were hospitalized less than TPN group(p,0.05).The level of all the indicators in EEN group were lower than in TPN group at postoperative day 1 and day 10 and,between two groups,there was significant difference in transferrin(P0.05)and prealbumin(P0.01).Conclusion Compared with TPN,EEN can promote the recovery of bowel function,shorten hospital days and improve nutritional statu in gastric cancer surgical patients. 　　【Key words】 Gastric cancer; Total gastrectomy; Enteral nutrition; Par-enteral nutrition 　　 　　营养支持治疗是胃癌患者术后的重要组成部分,但既往术后早期多以应用TPN为主。为探讨因胃癌行全胃切除的患者术后早期肠内营养的可行性及疗效,现将我院2004年4月至2009年4月收治的48例胃癌行全胃切除术患者,分为EEN组及TPN组,并进行统计分析对比,现报告如下。 　　1 资料和方法 　　 　　作者单位:515100广东省汕头市潮阳区人民医院普外科