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目的观察胃癌根治术后早期肠内、外营养的疗效比较。方法选取复旦大学附属中山医院青浦分院2009年1月至2011年12月胃癌术后患者90例,随机分为观察组(n=45)和对照组(n=45),对照组予以肠外营养(PN),观察组予以早期肠内营养(EEN)。观察两组术后肛门排气时间、住院时间、体重下降、上臂肌围、血红蛋白、白蛋白(ALB)、转铁蛋白(TF)、前白蛋白(PA)、高敏C反应蛋白(hs-CRP)和并发症发生率的情况。结果 EEN组的术后肛门排气时间、住院时间和体重下降均较PN组出现明显缩短或减少(P<0.05或<0.01);治疗后PN组的ALB和TF的水平较治疗前和EEN组出现明显降低(P<0.01),两组的AP和hs-CRP水平较治疗前明显降低或者升高(P<0.01),PN组的降低或者升高水平更为明显,差异均有统计学意义(P<0.01)。两组的上臂肌围、血红蛋白水平和术后并发症发生率差异无统计学意义(P>0.05)。结论 EEN改善胃癌根治术后患者的营养状况,降低炎症反应,是理想的营养支持方式。
Objective To observe the curative effect of early enteral nutrition and external nutrition after radical operation of gastric cancer. Methods Ninety patients with postoperative gastric cancer from January 2009 to December 2011 in Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University were randomly divided into observation group (n = 45) and control group (n = 45). The control group was given parenteral nutrition (PN). The observation group was given early enteral nutrition (EEN). The time of postoperative anal exhaust, length of hospital stay, weight loss, upper arm muscular circumference, hemoglobin, albumin (ALB), transferrin (TF), prealbumin (PA), high sensitivity C-reactive protein ) And the incidence of complications. Results The postoperative anal exhaust time, hospital stay and weight loss in EEN group were significantly shorter or shorter than those in PN group (P <0.05 or <0.01). After treatment, the levels of ALB and TF in PN group were significantly lower than those in EEN group (P <0.01). The AP and hs-CRP levels in both groups were significantly lower or higher than those before treatment (P <0.01), and the levels of PN or Pscreased or increased more significantly in both groups (P <0.01). There was no significant difference in the upper arm muscle circumference, hemoglobin level and the incidence of postoperative complications between the two groups (P> 0.05). Conclusion EEN can improve the nutritional status of patients after radical operation of gastric cancer and reduce the inflammatory reaction, which is an ideal nutritional support.