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目的:观察胃癌手术围术期肠内营养与肠外营养支持治疗效果。方法:将胃癌40例随机分为肠内营养治疗组(EN组)和肠外营养支持治疗组(PN组)各20例,EN组于术前2天开始应用肠内营养液,共9天;PN组于术后第1天起给予肠外营养支持,共7～10天。比较两组术前、术后第1、3、7天的PAB、ALB、TF、CD3、CD4、CD8、CD4/CD8、IgG、IgA、IgM、CRP、C3和C4水平变化,术后胃肠道功能恢复时间、住院时间、住院费用及并发症发生情况。结果:两组术后第1天PAB、ALB水平非常显著低于术前(P<0.01);EN组CD3、CD4、CD4/CD8水平显著高于PN组(P<0.05),CD8水平显著低于PN组(P<0.05);EN组IgG、IgA、IgM水平显著高于PN组(P<0.05);EN组CRP水平显著低于PN组(P<0.05);EN组术后胃肠道功能恢复时间显著早于PN组(P<0.05);住院时间、住院费用显著少于PN组(P<0.05)。结论:胃癌手术围术期肠内营养治疗安全,效果优于肠外营养支持治疗。
Objective: To observe the effect of perioperative enteral nutrition and parenteral nutrition in gastric cancer surgery. Methods: Forty gastric cancer patients were randomly divided into enteral nutrition group (EN group) and parenteral nutrition support group (PN group), 20 cases each. EN group started enteral nutrition solution 2 days before operation for 9 days ; PN group give parenteral nutrition support on the first day after operation, a total of 7 to 10 days. The levels of PAB, ALB, TF, CD3, CD4, CD8, CD4 / CD8, IgG, IgA, IgM, CRP, C3 and C4 in the two groups were compared before and 1, Road function recovery time, hospital stay, hospitalization costs and complications. Results: The levels of PAB and ALB on the first postoperative day in the two groups were significantly lower than those before operation (P <0.01). The levels of CD3, CD4 and CD4 / CD8 in EN group were significantly higher than those in PN group (P <0.05) (P <0.05). The levels of IgG, IgA and IgM in EN group were significantly higher than those in PN group (P <0.05), CRP level in EN group was significantly lower than that in PN group (P <0.05) The functional recovery time was significantly earlier than PN group (P <0.05). The hospitalization time and hospitalization cost were significantly less than those in PN group (P <0.05). Conclusion: The perioperative enteral nutrition for gastric cancer is safe and effective than parenteral nutrition support.