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[目的]分析快速康复外科理念对胃癌手术后营养支持效果的影响,总结其应用体会.[方法]以本院2014年2月至2017年2月收治的86例老年胃癌患者为研究对象,进行前瞻性对照分析.按照随机数表法将患者分为观察组、对照组,各43例,两组均实施胃癌根治术治疗,术后给予常规镇痛、营养支持等综合干预.在此基础上,观察组加用基于快速康复外科理念的营养支持.比较两组患者干预前后营养状态、免疫功能变化以及恢复情况、并发症发生情况,分析快速康复外科理念在营养支持中的指导价值.[结果]术后7d两组患者总蛋白、白蛋白均较术前1d上升,观察组术后7d总蛋白、白蛋白均高于对照组,差异有统计学意义(P＜0.05).与术前1d相比,观察组术后7 d CD3+、CD4+上升,CD8+下降,差异有统计学意义(P＜0.05).观察组术后肠鸣音恢复时间、肛门排气时间、住院时间均低于对照组,差异有统计学意义(P＜0.05).观察组术后并发症发生率为6.98％,低于对照组的30.23％,差异有统计学意义(P＜0.05).[结论]基于快速康复外科的术后营养支持能够明显改善老年胃癌患者术后营养状态及免疫功能,对于缩短恢复时间、降低术后并发症发生风险亦具有积极意义.“,”[Objective] To analyze the effect of fast track surgery on nutritional support after gastrectomy for gastric cancer,and summarize the application experience.[Methods] A total of 86 elderly patients with gastric cancer treated in our hospital from February 2014 to February 2017 were enrolled in this study and were prospectively analyzed.According to the random number table method,the patients were divided into observation group and control group,43 cases each.The two groups were treated with radical gastrectomy,postoperative routine analgesia and nutritional support were comprehensively intervened.On this basis,the observation group was given nutritional support based on the concept of fast track surgery.The nutritional status,immune function,recovery and complications were compared between the two groups before and after intervention.The guiding value of the concept of fast track surgery in nutritional support was analyzed.[Results]At 7 d after operation,the total protein and albumin of the two groups increased compared with the preoperative 1 d;the total protein and albumin of 7 d after operation in the observation group were higher than those in the control group,the difference was statistically significant (P ＜0.05).Compared with the preoperative 1 d,CD3+,CD4+ of 7 d after operation in the observation group increased,CD8+ decreased,the difference was statistically significant (P ＜0.05).Postoperative recovery time of bowel sound,anal exhaust time,hospitalization time in the observation group were lower than the control group,the difference was statistically significant (P ＜0.05).The incidence of postoperative complications in the observation group was 6.98％,which was lower than that of the control group (30.23 ％),and the difference was statistically significant (P ＜0.05).[Conclusion]Postoperative nutritional support based on fast track surgery can significantly improve the nutritional status and immune function of elderly patients with gastric cancer after operation,which has a positive significance for shortening the recovery time and reducing the risk of postoperative complications.