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目的研究营养支持对近端胃次全切除术后患者血浆ghrelin水平的影响。方法选择83例行近端胃癌根治术的T1～3N0～1M0胃癌患者,根据营养支持方式将患者分为肠内营养组(A组,43例)和肠外营养组(B组,40例)。测定手术当天、术后第1、3、7、9天血浆ghrelin水平。结果两组术后第1天血浆ghrlein水平下降至最低点,分别为术前的(33.2±4.2)%和(34.1±3.7)%。术后第3天,A组血浆ghrlein水平的回升快于B组[(47.2±6.2)%vs.(38.4±5.7)%](P<0.05);至术后第9天,两组的回升幅度才相仿,分别为术前的(70.4±5.9)%和(67.1±6.3)%(P>0.05)。结论肠内营养较肠外营养更能促进近端胃次全术后患者血浆ghrelin水平的恢复。
Objective To investigate the effect of nutritional support on plasma ghrelin levels in patients undergoing subtotal gastrectomy. Methods Totally 83 patients with T1 ~ 3N0 ~ 1M0 gastric cancer who had undergone radical resection of gastric cancer were divided into two groups: enteral nutrition group (n = 43) and parenteral nutrition group (n = 40) . The level of plasma ghrelin was measured on the day of surgery and on the 1st, 3rd, 7th and 9th day after operation. Results The levels of plasma ghrlein decreased to the lowest point on the first postoperative day in the two groups (33.2 ± 4.2% vs 34.1 ± 3.7%, respectively). On the third day after operation, the level of ghrlein in group A rose faster than that in group B [(47.2 ± 6.2)% vs (38.4 ± 5.7)%] (P <0.05) The amplitudes were similar, preoperatively (70.4 ± 5.9)% and (67.1 ± 6.3)%, respectively (P> 0.05). Conclusions Enteral nutrition can promote the recovery of plasma ghrelin in patients with proximal gastric bypass after parenteral nutrition.