文章摘要
周宪 樊春波 胡长江 杨仕明 万跃.早期肠内及肠外营养支持对老年胃癌术后的运用分析[J].,2015,15(19):3668-3670
早期肠内及肠外营养支持对老年胃癌术后的运用分析
Application of Early Enteral and Parenteral Nutrition Support onElderly Patients with Postoperative Gastric Carcinoma
  
DOI:
中文关键词: 营养支持  肠内营养  肠外营养  老年  胃癌
英文关键词: Nutritional support  Enteral nutrition  Parenteral  Nutrition Elderly  Gastric cancer
基金项目:国家自然科学基金项目(81402034,30900679)
作者单位
周宪 樊春波 胡长江 杨仕明 万跃 重庆市肿瘤研究所放疗科中国人民解放军第三军医大学附属第一医院(西南医院)肿瘤科 
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中文摘要:
      目的:探讨早期肠内及肠外营养支持对老年胃癌术后的运用,为改善患者的预后提供临床指导。方法:选取我院2008 年2 月~2014 年2 月收治的152 例老年胃癌患者,分别纳入肠内营养(Enteral nutrition,EN)组(51 例)、肠外营养(Parenteral nutrition, PN)组(51 例)及EN 联合PN 组(50 例),比较各组患者术后并发症、营养指标、血清指标及住院情况等,分析老年胃癌术后的最佳 营养支持方案。结果:EN 组胃肠道功能恢复时间为(46.3± 5.2)h,PN 组为(51.4± 7.3)h,EN 联合PN 组为(41.9± 4.4)h,EN联合 PN 组胃肠道功能恢复时间显著低于其他两组(P<0.05);三组患者术后白蛋白、转铁蛋白、前白蛋白及CD8 测定值无明显统计学 差异(P>0.05),EN 联合PN 组血清C 反应蛋白、CD4 显著低于其他两组,CD3 和CD4/CD8 显著高于其他两组(P<0.05);EN联 合PN组感染性并发症发生率及住院时间均显著低于其他两组(P<0.05),其治疗费用介于EN 组和PN组之间。结论:肠内联合 肠外序贯营养支持较单纯肠内营养或肠外营养支持具有高效、合理、经济、安全等多种优势,能够促进患者消化吸收功能的恢复, 改善老年胃癌患者预后和生存质量,值得各级医院推广应用。
英文摘要:
      Objective:To explore the application of the early enteral and parenteral nutrition support after operation on the elderly patients with gastric carcinoma, to provide clinical guidance for the prognosis of the patients.Methods:152 cases of elderly patients with gastric cancer in our hospital fromAugust in 2010 August to August in 2013, were divided into enteral nutrition group (Enteral nutrition, EN) (51 cases), parenteral nutrition group (Parenteral nutrition, PN) (51 cases), and EN + PN group (50 cases). The complications, nutritional index, serum index and hospitalization of patients after operation among three groups were compared, and the best nutrition support for elderly patients with gastric carcinoma after operation was analyzed.Results:The recovery time of gastrointestinal function was (46.3± 5.2) h in EN group , (51.4± 7.3) h in PN group, and (41.9± 4.4) h in EN + PN group, and it was significantly lower in EN + PN group than that of the other two groups. The level of postoperative albumin, transferrin, prealbumin and CD8 had no statistical difference (P > 0.05), while the serum C reactive protein and CD4 in EN + PN group was significantly lower than that of the other two groups, and the level of CD3, CD4/CD8 was significantly higher than the other two groups (P < 0.05); the infectious complication rate and hospital stay in EN + PN group were significantly lower than the other two groups (P < 0.05), but the cost of treatment wasbetween EN group and PN group.Conclusion:EN combined with PN sequential support has high efficiency, reasonality, economy, safety and other advantages. It can promote the recovery of digestive and absorptive function of patients, and improve the prognosis and quality of life, and is worthy to be popularized in clinic.
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