摘要
探讨胃癌术后早期肠内营养的可行性、安全性和临床效果，并与全肠外营养作一合理比较。材料与方法：６０例进展期胃癌患者术后第一天随机分为全肠外营养（ＴＰＮ组，ｎ＝１９）、肠内营养（ＥＮ组，ｎ＝２３）和常规补液（对照组，ｎ＝１８）３组，并分别在营养支持前、后各一次测定体重、肝肾功能、血糖、电解质、血浆蛋白、血红蛋白、免疫球蛋白、淋巴细胞计数和血胃泌素，临床观察生命体征、胃肠道功能恢复情况及各种不良反应。结果：３组病例在研究期间无死亡，无严重并发症，肝肾功能无明显变化。ＴＰＮ及ＥＮ组血浆白蛋白、前白蛋白和转铁蛋白水平营养支持后明显升高（Ｐ＜０．０５），体重下降减缓。ＥＮ组血胃泌素水平在肠道营养后明显升高（Ｐ＜０．０５）。临床观察ＥＮ组肛门恢复排气时间较ＴＰＮ和对照组显著缩短（Ｐ＜０．０５）。结论：胃癌术后早期肠内营养支持安全、可行，在改善机体营养状态方面具有与传统的全肠外营养支持相似的效应，并有促进和维护胃肠道功能，刺激胃肠道激素分泌的作用，同时费用较低。
To explore the feasibility and safety of early post-operative enteral nutrition(EN) for gastric cancer. Its effects were reasonably compared with that of TPN. Methods: 60 cases of advanced gastric cancer were randomly divided into a TPN group(n=19), an EN group(n = 23) and a control group(n=18) without any nutritional support. Parameters including the body weight, the renal and liver functions, serum glucose, electrolytes, plasma protein, Hb, immunoglobulin, lymphocyte count and gastrin were measured before and after nutritional support. The complications, vital signs and resumption of gastrointestinal function were carefully observed. Results: No mortality and serious morbidity occurred in all the groups, neither was there any evidence of impaired renal and liver functions. The levels of serum albumin, prealbumin and transferrin were significantly elevated after nutritional support both in the TPN and EN groups(p< 0.05), while the decline in body weight attenuated as compared with the control group. The serum gastrin concentration was significantly increased in the EN group(p<0.05), whereas no such changes was observed in both the TPN and control groups. The bowel movement resumed significantly earlier in the EN group than in the other two groups. Conclusions: Early post-operative EN for gastric cancer patients is safe and feasible. While producing similar nutritional effects as that of TPN, En is superior to TPN in terms of resumption of gastrointestinal function, and of stimulation of digestive hormone secretion besides, it is more cost-effective.
出处
《外科理论与实践》
2000年第1期17-20,共4页
Journal of Surgery Concepts & Practice
关键词
胃肿瘤
早期肠内营养
全肠外营养
手术后
Gastric cancer Early enteral nutrition Total parenteral nutrition
