论文部分内容阅读
目的观察肠内营养联合肠外营养(EPN)和单用肠外营养(PN)对早期胃癌术后患者的疗效差异。方法 80例早期胃癌患者随机分为A、B两组,各40例,A组采用EPN,B组采用PN营养支持。于术后第1天和第8天检测两组血清白蛋白(ALB)、前清蛋白(PA)、C反应蛋白水平(CRP),并观察记录两组并发症发生率情况。结果两组术后第1天ALB、PA、CRP无明显差异;A组术后第8天ALB、PA有所增长,分别由(35.47±3.95)g/L、(263.32±24.54)g/L增至(38.10±3.47)g/L、(276.19±22.27)g/L,B组术后第8天ALB、PA无明显增长,两组比较差异有统计学意义(P<0.05);两组术后第8天CRP均明显降低,A组由(17.5±4.6)mg/L降至(3.1±2.0)mg/L,B组由(16.9±4.9)mg/L降至(4.7±2.2)mg/L,A组降低幅度优于B组,有统计学意义(P<0.05)。A组患者吻合口瘘的发生率为2.5%,肺部感染发生率为5%,胸腔积液发生率为5%,切口愈合不良发生率为0;B组患者吻合口瘘的发生率为7.5%,肺部感染发生率为15%,胸腔积液发生率为10%,切口愈合不良发生率为7.5%,两组并发症发生率比较差异有统计学意义(P<0.05)。结论早期胃癌术后应用EPN营养支持相对PN可保证患者营养供给、调节免疫功能、促进组织修复、降低术后并发症的发生率,可作为早期胃癌术后首选营养支持方法。
Objective To observe the curative effect of enteral nutrition combined with parenteral nutrition (EPN) and parenteral nutrition (PN) on postoperative patients with early gastric cancer. Methods Eighty patients with early gastric cancer were randomly divided into A and B groups, 40 cases in each group. EPN was used in group A and PN nutrition was used in group B. Serum albumin (ALB), prealbumin (PA) and C-reactive protein (CRP) levels were measured on the first day and the eighth day after operation. The complication rates were recorded and recorded. Results There was no significant difference in ALB, PA and CRP on the first day after operation between the two groups. ALB and PA increased on the 8th day after operation in group A (35.47 ± 3.95 g / L, (263.32 ± 24.54) g / L (38.10 ± 3.47) g / L and (276.19 ± 22.27) g / L, respectively. There was no significant increase in ALB, PA on the 8th day after operation in group B. The difference between the two groups was statistically significant (P <0.05) The level of CRP decreased significantly from (17.5 ± 4.6) mg / L to (3.1 ± 2.0) mg / L in group A and from (16.9 ± 4.9) mg / L to (4.7 ± 2.2) mg / L. The decrease in group A was better than that in group B, which was statistically significant (P <0.05). In group A, the incidence of anastomotic fistula was 2.5%, the incidence of pulmonary infection was 5%, the incidence of pleural effusion was 5% and the incidence of incision healing was 0. The incidence of anastomotic fistula in group B was 7.5 %, The incidence of pulmonary infection was 15%, the incidence of pleural effusion was 10%, and the incision healing rate was 7.5%. There was significant difference in the complication rates between the two groups (P <0.05). Conclusion The postoperative application of EPN nutrition support for early gastric cancer can ensure nutritional supply, regulate immune function, promote tissue repair and reduce the incidence of postoperative complications. It can be used as the first choice of nutritional support after early gastric cancer.