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胃癌全胃切除术后早期肠内营养的临床效果
彭德伟,汪雪,周礼,李锋,王梦桥,葛海龙
0
(成都市第五人民医院外科)
摘要:
【摘要】目的 探讨胃癌全胃切除术后早期肠内营养的临床效果。方法 选取2012年5月~2017年5月在我院行全胃切除术胃癌患者124例,随机分为肠内营养组和肠外营养组,每组各62例。两组均采用全胃切除和食管空肠RouxenY吻合术,术后均预防感染。肠内营养组在食管空肠吻合口下40cm置入鼻肠管,采用肠内营养支持治疗。肠内营养剂1000ml含蛋白质40g、碳水化合物123g、脂肪389g、维生素026g、微量元素424g。肠外营养组使用三升袋(葡萄糖、复方氨基酸、脂肪乳、多种维生素和微量元素)静脉滴注。观察体质量、血清白蛋白、血红蛋白肛门排气时间、住院时间和不良反应。结果 经1周营养支持治疗后,肠内营养组和肠外营养组的体质量、血清白蛋白和血红蛋白差异均无统计学意义(P>005);肠内营养组的肛门排气时间和住院时间短于肠外营养组,差异有统计学意义(P<005);肠内营养组的不良反应率低于肠外营养组(P<005)。结论 胃癌手术后早期采用肠内营养能促进肠道功能及早恢复,可缩短住院时间,减少不良反应。
关键词:  胃癌  全胃切除术  早期肠内营养  临床效果
DOI:
基金项目:四川省卫计委科研课题(17Z008)
The clinical effect of early enteral nutrition after total gastrectomy for gastric cancer
PENG Dewei,WANG Xue,ZHOU Li,LI Feng,WANG Mengqiao,GE Hailong
(Department of Surgery, Chengdu Fifth People Hospital)
Abstract:
【Abstract】 Objective To explore The clinical effect of early enteral nutrition after total gastrectomy for gastric cancer. Methods 124 patients with total gastrectomy for gastric cancer were divided into EEN group (62 cases) and TPN group (62 cases). EEN group and TPN group were treated with total gastrectomy and RouxenY anastomosis of esophagojejunostomy and prevented infection with antibiotics. EEN group was treated with early enteral nutrition. TPN group was treated with total parenteral nutrition. The body mass, serum total protein, serum albumin, anus exhaust time, time of hospitalization and adverse effects were observed. Results The body mass, serum total protein, serum albumin 1 week after treatment of EEN group were not significantly different from that of TPN group (P>005). The anus exhaust time, time of hospitalization of EEN group were shorter than that of TPN group (P<005). The incidence of adverse effects of EEN group and TPN group were 1613% and 3065% (P<005). Conclusion Early enteral nutrition can promote recovery of bowel function, shorten the time of hospital and reduce the adverse effect of patients with total gastrectomy for gastric cancer.
Key words:  Gastric cancer  Total gastrectomy  Early enteral nutrition  Clinical effect

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