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[早期肠内营养对胃癌手术后临床结局的影响]

[Effect of early oral enteral nutrition on clinical outcomes after gastric cancer surgery].

作者信息

Mi Lei, Zhong Bei, Zhang Dian-liang, Zhou Yan-bing, Wang Dong-sheng

机构信息

Department of General Surgery, Qingdao University, Qingdao, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2012 May;15(5):464-7.

Abstract

OBJECTIVE

To investigate the effect of early oral feeding with enteral nutrition preparation after surgery on clinical outcomes in patients with gastric cancer.

METHODS

Sixty patients with gastric cancer undergoing radical operation between July 2010 and May 2011 were randomly divided into two groups using random digit table: experimental group(n=30, administration of water and enteral nutrition early after surgery) and control group(n=30, conventional postoperative care protocol). Clinical outcomes, immune function, and nutritional status between the two groups were compared.

RESULTS

As compared to the control group, duration of fever was significantly shorter in the experimental group [(81.1±6.4) h vs. (87.3±8.0) h, P<0.05], as were postoperative time of flatus [(79.9±9.5) h vs. (86.6±8.7) h, P<0.05] and postoperative hospital stay [(7.83±2.23) d vs. (9.57±1.96) d, P<0.01]. The medical cost [(30,220±3,220) RMB vs.(34,600±32,120) RMB, P<0.01] was lower than that in the control group. There was no significant difference in morbidity between the two groups[13.3%(4/30) vs. 16.7%(5/30), P>0.05]. The levels of CD3(+)T, CD4(+)T, NK cell, CD4(+)T/CD8(+)T, albumin, and prealbumin were higher in the experimental group as compared to the control group on postoperative day 3 and 7(P<0.05).

CONCLUSION

Early oral feeding with enteral nutrition preparation after surgery can improve the nutritional status and immune function, and accelerate the rehabilitation for patients with gastric cancer.

摘要

目的

探讨胃癌患者术后早期经口给予肠内营养制剂对临床结局的影响。

方法

选取2010年7月至2011年5月间行根治性手术的60例胃癌患者,采用随机数字表法将其随机分为两组:试验组(n = 30,术后早期给予水和肠内营养)和对照组(n = 30,采用传统术后护理方案)。比较两组患者的临床结局、免疫功能和营养状况。

结果

与对照组相比,试验组发热持续时间显著缩短[(81.1±6.4)小时 vs.(87.3±8.0)小时,P < 0.05],术后排气时间[(79.9±9.5)小时 vs.(86.6±8.7)小时,P < 0.05]和术后住院时间[(7.83±2.23)天 vs.(9.57±1.96)天,P < 0.01]也显著缩短。医疗费用[(30220±3220)元 vs.(34600±32120)元,P < 0.01]低于对照组。两组患者的发病率无显著差异[13.3%(4/30) vs. 16.7%(5/30),P > 0.05]。术后第3天和第7天,试验组的CD3(+)T、CD4(+)T、NK细胞、CD4(+)T/CD8(+)T、白蛋白和前白蛋白水平均高于对照组(P < 0.05)。

结论

胃癌患者术后早期经口给予肠内营养制剂可改善营养状况和免疫功能,加速康复。

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