摘要
目的探讨胃癌病人行全胃切除术后早期行肠内营养的安全性、临床疗效及对机体免疫功能的影响。方法选择因胃癌行全胃切除术的76例病人,随机分为两组:对照组和试验组各38例,术后对照组经外周静脉输注营养液,试验组进行早期肠内营养,两组基本等热量营养连续给予7d,对两组病人的术前、术后营养状态进行评价,并比较手术前后免疫功能指标及肝、肾功能等生化指标等。结果术后第1天,两组病人的各项免疫指标均有所下降,而术后第8天两组的TSF、AMC、TRF、TLC、DCH、IgG、IgM、IgA、CD3、CD4和CD4/CD8均明显回升,并高于术前水平,两组比较差异有显著性意义(P<0.05);对照组支持后血糖较术前显著增高(P<0.01)而试验组支持前后无显著变化(P>0.05)。支持前后两组肝功能变化无明显差异(P>0.05)。两组病人支持后营养指标均有所提高,试验组增高幅度较对照组大,但无显著差异(P>0.05)。结论胃癌病人全胃切除术后早期行肠内营养是有效的,可改善机体营养状况和病人的免疫功能等,而且安全性较高。
Objective To explore the whole line of safety and efficacy and on immune function of early postoperative enteral nutrition support after total gastrectomy. Methods For total gastrectomy, 76 patients were randomly divided into two groups：the control group and test group, each group 38 cases,the control group received weeks of intravenous infusion of nutrient solution,and test group received early enteral nutrition, the two group basic nutrition, such as heat for seven days, to evaluate two groups of patients pre- and postoperative nutritional status, and to compare immune function and liver and kidney function,and other biological indicators. Results After the f＇wst day, the immune indicators of two groups of patients have declined, while on the eighth after operation two groups of the TSF, AMC, TRF, TLC, DCH, IgG, IgM, IgA, CD3, CD4 and CD4/CD8 were significantly rebound, and higher than the preoperative level. Difference between the two groups was significant（P 〈 0.05 ）. The control group patients＇ blood glucose level was higher than preoperative significantly in preoperative （P 〈 0.01 ）, and the test group was no significant change （P 〉 0.05）. The changes in liver function pre-and postoperative the two groups there was no significant difference （P 〉 0.05）. Two groups of patients＇ nutrition indicators have improved after received nutrition support, the test group increased rate higher than the control group,but no significant difference（P〉0.05）. Conclusion The early enteral nutrition is effective, can improve the nutritional status of the body and the patient＇s immune function, and higher security.
出处
《中国现代医生》
2008年第30期1-2,20,共3页
China Modern Doctor
关键词
胃癌
早期肠内营养
全胃切除术
Gastric cancer
Early enteral nutrition
Total gastrectomy
