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目的:观察胃肠根治术后早期应用肠内营养的疗效及不良反应。方法:选取我院2012年1月到2012年6月住院进行手术治疗的胃癌患者36例,随机分成2组,每组18例。对照组进行常规的肠外营养支持,观察组通过术中放置空肠造瘘管给予能全力。观察并记录所有患者术后排气时间、术后排便时间、流质饮食时间、半流质饮食时间、住院总天数及术后并发症;于术前1d及术后第7d采集静脉血检测总蛋白、前白蛋白、白蛋白及血红蛋白的含量。结果:术后观察组和对照组排气时间分别为(3.14±1.12)d和(4.68±1.20)d、排便时间分别为(4.41±1.23)d和(5.67±1.41)d、流质饮食时间分别为(5.23±1.41)d和(6.21±1.54)d、半流质饮食时间分别为(8.12±1.65)d和(9.65±1.45)d及住院时间分别为(14.0±2.21)d和(16.0±3.14)d,差异均具有统计学意义(P<0.05);与对照组相比较,观察组术后7d总蛋白、白蛋白、前白蛋白及血红蛋白的水平均显著增加(P<0.05);并发症发病率对照组显著高于观察组(P<0.05)。结论:早期肠内营养不仅可促进胃癌根治术术后胃肠功能的尽早恢复,还可显著改善术后患者营养状况,是一种胃癌患者术后有效、安全的营养支持方式。
Objective: To observe the curative effect and adverse reactions of early enteral nutrition after gastrointestinal radical operation. Methods: Thirty-six patients with gastric cancer hospitalized for surgical treatment from January 2012 to June 2012 in our hospital were randomly divided into two groups (18 in each group). The control group underwent routine parenteral nutrition support, and the observation group was able to exert its full force through intraoperative jejunal fistula administration. All the patients were observed and recorded for postoperative exhaust time, postoperative defecation time, liquid diet time, semi-liquid diet time, the total number of days hospitalized and postoperative complications; venous blood samples were collected at 1 day before operation and 7 days after operation, Prealbumin, albumin and hemoglobin content. Results: The evacuation time of observation group and control group after operation were (3.14 ± 1.12) d and (4.68 ± 1.20) days respectively, and the defecation times were (4.41 ± 1.23) d and (5.67 ± 1.41) days respectively Were (5.23 ± 1.41) d and (6.21 ± 1.54) days respectively, and the time of semi-liquid diet was (8.12 ± 1.65) days and (9.65 ± 1.45 days), and the hospital stay was (14.0 ± 2.21) days and (16.0 ± 3.14 days) ) d, the differences were statistically significant (P <0.05). Compared with the control group, the levels of total protein, albumin, prealbumin and hemoglobin in the observation group increased significantly (P <0.05) The incidence of the control group was significantly higher than that of the observation group (P <0.05). Conclusion: Early enteral nutrition can not only promote the early recovery of gastrointestinal function after radical operation of gastric cancer, but also significantly improve the nutritional status of postoperative patients. It is an effective and safe nutritional support for patients with gastric cancer.