胃癌患者术后应用肠内营养混悬液的临床观察(1)
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[摘要] 目的：通过应用肠内营养(百普力)，观察胃癌术后患者的营养状况，免疫状况，及感染发生率，以评价营养对患者的益处。方法：将80例患者随机分为两组，观察组术后在肠外营养内常规给以肠内营养，对照组仅给以肠外营养。观察愈合时间。结果：观察组在平均住院时间与对照组无差别，在感染发生率及营养恢复状况，免疫状态均明显改善。结论：胃癌术后患者给以肠内营养(百普力)后，其免疫状态及营养状况均有明显改善，减少感染发生率，患者可良好耐受。可加速患者愈合。
[关键词] 胃癌患者；肠内营养；百普力；临床观察
[中图分类号] R735.2 [文献标识码]A[文章编号]1674-4721(2011)08(b)-030-02
Clinical observation of postoperative application of enteral nutrition suspension in patients with gastric cancer
KONG Ye, HUA Yawei, ZHANG Zhandong, JI Sheqing
Department of General Surgery, Henan Tumor Hospital, Henan Province, Zhengzhou 450003, China
[Abstract] Objective: Through application of enteral nutrition suspension (Peptison) and observation of the postoperative nutritional status, immune status and infection incidence of patients with gastric cancer, to evaluate the benefits of nutrition for patients. Methods: 80 patients were randomly divided into two groups. The observation group was given enteral nutrition in addition to conventional parenteral nutrition while the control group was given only parenteral nutrition. The healing time was observed. Results: The observation group had no significant difference from the control group in the average length of stay while its infection incidence, nutritional recovery status and immune status significantly improved. Conclusion: Postoperative application of enteral nutrition suspension in patients with gastric cancer have significantly improved the immune status and nutrition status, reduced the infection incidence and accelerated the healing of patients. The patients may be well tolerated.
[Key words] Patients with gastric cancer; Enteral nutrition; Peptison; Clinical observation
胃癌是一种发病率很高的恶性肿瘤,在我国, 发病率达到40/10万[1]，在各种恶性肿瘤中的死亡率居首位。尤其在河南省，胃癌高发。同时，胃癌患者60%存在不同程度的营养不良[2]，经过手术打击，因自身营养物质不足，同时术后分解代谢加剧，导致免疫状态下降，会增加患者炎症反应及感染的机会，甚至导致多器官功能衰竭[3]。术后给以营养支持治疗，能够减少分解代谢，同时提供足够的氮促进合成。尤其是早期肠内营养支持，不仅能够提供能量，还对黏膜屏障有保护作用，减少细菌移位。防止术后感染，减轻炎症反应。笔者选取一组患者，给以肠内营养混悬液(百普力)，行肠内营养，观察患者各项生化指标的变化，以了解耐受性及益处。
1 资料与方法
1.1 一般资料
选择2009年1~4月河南省肿瘤医院普外科就诊胃癌患者40例，术后应用百普力给以早期肠内营养。同期未行肠内营养患者40例作为对照组。80例胃癌患者，年龄32~77岁，平均(49.0±14.1)岁，均为术后病理Ⅱa~Ⅳa期(分期标准按照AJCC第6版胃癌TNM分期)，随机分为两组。年龄分布见表1。
1.2 方法
1.2.1 研究方法和内容选取胃癌患者80例，均行D2手术[4]，手术顺利，无出血及梗阻导致二次手术病例。观察组40例术中放置“复尔凯营养管”置空肠上段20 cm处，术后除常规静脉营养外 ......
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