早期肠内营养与肠外营养在胃癌根治术后应用效果比较

刘洪一; 王白石; 张加金; 张秉栋; 薛勇敢; 贾宝庆

doi:10.3969/j.issn.1000-8179.20141362

早期肠内营养与肠外营养在胃癌根治术后应用效果比较

doi: 10.3969/j.issn.1000-8179.20141362

解放军总医院肿瘤外一科(北京市 100853)

详细信息

作者简介:
刘洪一硕士, 副主任医师。专业方向为消化道肿瘤微创治疗的研究。E-mail:libing301301@sina.com

通讯作者:
贾宝庆 baoqingjia@126.com

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出版历程
- 收稿日期: 2014-07-20
- 修回日期: 2014-08-20
- 刊出日期: 2020-12-29

The effect of early postoperative enteral nutrition and parenteral nutrition in gastric cancer

The First Department of Surgical Oncology, PLA General Hospital, Beijing 100853, China

More Information

Corresponding author: Baoqing JIA; E-mail: baoqingjia@126.com

摘要

摘要: 目的探讨胃癌根治术后分别实施早期肠内营养与肠外营养的临床效果, 为胃癌患者术后提供更好的营养支持治疗。方法回顾性分析本院2009年2月至2011年2月收治的接受胃癌根治术后行肠内营养及肠外营养患者各70例, 其中肠外营养组给予常规肠外静脉营养治疗, 肠内营养组在术后第1~5天给予肠内营养剂, 观察患者术后第1天和第7天血清白蛋白、血红蛋白、丙氨酸转氨酶、天冬氨酸转氨酶水平, 及血液中IgA、IgG、IgM和CD4⁺细胞、NK细胞、B淋巴细胞情况。结果肠内营养组术后第1天和第7天血清白蛋白、血红蛋白、丙氨酸转氨酶、天冬氨酸转氨酶水平显著优于肠外营养组, 差异有统计学意义(P < 0.05);同时肠内营养组患者术后第7天与术后第1天及肠外营养组术后第8天比较, IgA、IgG、IgM和CD4⁺细胞、NK细胞、B淋巴细胞显著升高, 差异有统计学意义(P < 0.05)。结论胃癌患者术后早期肠内营养可有效改善术后营养水平, 以及免疫相关指标, 具有临床使用价值。
- 胃癌 /
- 肠外营养 /
- 肠内营养 /
- 临床效果
Abstract: Objective To study the clinical effect of early postoperative enteral nutrition and parenteral nutrition after radical excision of gastric cancer to provide a better way of treating gastric cancers. Methods Retrospective analysis of 140 gastric cancer patients who were admitted to the PLA General Hospital between February 2009 and February 2011 was conducted. These patients were randomized into two groups based on the clinical trial, i.e., 70 in the control group received an intravenous parenteral nutrition for the treatment, and for the other 70 in the observation group, jejunostomy was done 1 to 5 days after the radical surgery by using Supportan as the enteral nutritional agent with a dose of at TPF-T 500 mL/d to 1 000 mL/d. The postoperative long-term survival rate of the patients, the serum albumin, hemoglobin, alanine aminotransferase, aspartate aminotransferase levels before and after the treatment, as well as the situation of IgA, IgG, IgM and CD4+ cells, NK cells, and B lymphocytes in the blood at the first and the seventh day after surgery were observed in the patients. Results After the implementation of early enteral nutrition in the observation group, the 1- and 3-year survival rates were 84.29% (59/70) and 61.43% (43/70) respectively, whereas in the control group, the survival rates were 64.29% (45/70) and 47.143% (33/70) respectively, with statistically significant differences between the two groups (P < 0.05). At the first and seventh day after surgery, the serum albumin, hemoglobin, alanine aminotransferase, and aspartate aminotransferase levels were significantly better in the observation group than in the control group, with statistically significant differences between the two (P < 0.05). Compared with the parameters in the observation group at the first day after surgery and those in the control groups at the eighth day after surgery, the levels of IgA, IgG, IgM and CD42+ cells, NK cells, and B lymphocytes were significantly increased in the observation group at the seventh day after surgery. The differences among them were statistically significant (P < 0.05). Conclusion Early postoperative enteral nutrition for the gastric cancer patients undergoing radical surgery can be effective in improving the nutrition level of the patients and in enhancing their long-term survival rate, Thus, the treatment has value in clinical application.
- gastric cancer /
- parenteral nutrition /
- enteral nutrition /
- clinical effects

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表 1 术后第1、7天血清相关指标水平比较

Table 1. Comparison of serum ALB, HGB, ALT and AST on day 1 and day 7 after surgery

表 2 术后第1、7天相关体液免疫指标比较(g/L)

Table 2. Comparison of IgA, IgG and IgM in two groups(g/L)

表 3 两组患者术后第1及7天相关细胞免疫指标比较(%)

Table 3. Comparison of CD4⁺, NK cells and B lymphocytes in two groups(%)

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