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摘要目的：研究肠内营养、肠外营养、常规补液对胃癌术后患者临床结局的影响。方法：择我院住院治疗并行外科手术治疗的胃癌患者183 例，随机分至肠内营养组、肠外营养组、常规补液组，分别行相应的营养支持治疗，比较三组患者术前/ 后1 天及术后 8 天体重、白蛋白、淋巴细胞计数的变化及术后并发症发生情况、营养支持费用、术后住院时间、总费用。结果：常规补液组术后第 8 天体重较术前1 天明显下降；肠内、肠外营养组患者体重下降幅度均明显低于常规补液组；肠内、肠外营养组术后第8 天白蛋白水平升高显著，且明显高于常规补液组；肠内营养组患者术后第8 天淋巴细胞明显上升，且较常规补液组有明显升高。肠外营养组、常规补液组患者肝功能损害、血脂升高、血糖升高的发生率均明显高于肠内营养组；肠外营养组患者肝功能损害、血脂升高发生率明显低于常规补液组；肠内营养组患者切口腹腔感染及肺部感染的发生率均明显低于常规补液组。与常规补液组相比，肠外、内营养组患者术后住院时间均明显缩短，肠内营养组患者总费用明显偏高；与肠外营养相比，肠内营养组、常规补液组营养支持费用明显降低，肠内营养组患者总费用显著下降，上述差异均有统计学意义（P＜0.05）。结论：胃癌术后患者行肠内营养可大大降低术后并发症的发生，并减少患者住院费用，缩短术后住院时间。

英文摘要:

ABSTRACT Objective:To study the effect of enteral nutrition, parenteral nutrition, conventional fluid resuscitation on patients with gastric cancer. Methods:183 patients with gastric cancer were selected in our hospital, they were randomly divided to enteral nutrition group, parenteral nutrition group, conventional resuscitation group, with corresponding nutritional support treatment, the body weight of patients before and after 1 days and 8 days postoperative, albumin, lymphocyte, postoperative complications, nutritional support costs, postoperative hospitalization time, and total cost among these groups were compared. Results:The body weight of the patients in conventional resuscitation group decreased significantly on the eighth day after operation; the decrease of body weights of enteral nutrition and parenteral nutrition group were significantly lower than those of conventional resuscitation group; The albumin and lymphocyte of the patients in conventional resuscitation group increased significantly on the eighth day after operation. The indexes of impaired liver function, elevated blood lipids, and blood glucose of conventional resuscitation group were significantly higher than that of enteral nutrition group. Compared with the conventional resuscitation group, the hospitalization time of parenteral, enteral nutrition group shortened significantly postoperative, the total cost of enteral nutrition group were significantly higher. Compared with parenteral nutrition group, the nutritional support costs of enteral nutrition group, and conventional resuscitation group was significantly reduced, the differences were statistically significant (P<0.05).Conclusion: The enteral nutrition can greatly reduce the incidence of postoperative complications of the patients with gastric cancer, and can reduce the cost of hospitalization, shorten the days of hospitalization after operation.

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