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目的研究延期留置空肠穿刺造口管间断肠内营养在进展期胃癌术后辅助化疗中应用的可行性及其临床疗效。方法将进展期胃癌术后行辅助化疗的72例病人随机分成A、B两组,各36例。均于术中放置空肠穿刺造口管,A组延期留置空肠穿刺造口管至化疗6个疗程结束,每个化疗疗程经空肠穿刺造口管给予肠内营养液;B组于化疗前拔除空肠穿刺造口管,每个化疗疗程给予普通饮食。比较化疗后两组,观察延期留置空肠穿刺造口管相关并发症。结果化疗后A组血红蛋白、血清白蛋白、前白蛋白及IL-2、NK细胞活性、CD3+、CD4+、CD4+/CD8+水平显著高于B组(P>0.05);化疗期间A组呕吐发生率显著低于B组,平均每日摄入量显著多于B组(P<0.05),延期留置空肠穿刺造口管未发生相关严重并发症。结论延期留置空肠穿刺造口管间断肠内营养在进展期胃癌术后辅助化疗中应用是安全可行的,可以有效地提高术后辅助化疗病人的营养及免疫状况。
Objective To investigate the feasibility and clinical efficacy of postoperative intermittent enteral nutrition with jejunal aspiration stoma for postoperative adjuvant chemotherapy for advanced gastric cancer. Methods A total of 72 patients undergoing adjuvant chemotherapy for advanced gastric cancer were randomly divided into two groups, A and B, with 36 patients in each group. The jejunostomy stoma was placed during the operation. In Group A, the jejunostomy stoma was postponed until the end of the 6 cycles of chemotherapy. Each chemotherapy course was administered with enteral nutrition via the jejunostomy stoma; the jejunum was removed before chemotherapy in the group B. Puncture the stoma and give an ordinary diet for each chemotherapy session. After the two groups of chemotherapy were compared, complications related to delayed jejunostomy puncture were observed. Results The levels of hemoglobin, serum albumin, prealbumin, IL-2, NK cells, CD3+, CD4+ and CD4+/CD8+ in group A after chemotherapy were significantly higher than those in group B (P>0.05). The incidence of vomiting was significant in group A during chemotherapy. Lower than group B, the average daily intake was significantly more than in group B (P < 0.05). Delayed indwelling jejunostomy stoma no serious complications. Conclusion The use of delayed enteral jejunostomy stoma for interruption of enteral nutrition in postoperative adjuvant chemotherapy for advanced gastric cancer is safe and feasible, and can effectively improve the nutritional and immune status of postoperative adjuvant chemotherapy patients.