摘 要目的: 探讨胃肠道肿瘤术后不同营养支持途径对患者营养状况改善中的作用。方法:49肠道肿瘤手术患者随机分成两组, EN组( n=23)术后早期进食, TPN组( n=26)术后常规营养支持, 观察术后的临床表现, 检测细胞及体液免疫指标,检测术前、术后营养状况指标。结果: EN组胃肠功能恢复较TPN组快, 住院时间都较TPN少, 细胞免疫指标优于TPN组, 体液免疫指标两组无明显区别。血清总蛋白、白蛋白转铁蛋白水平各项指标中,EN组、TPN组较术前降低,但差异无显著性,TPN术后较术前显著下降(P<0.05)。结论:胃肠道肿瘤术后早期进食有利于加快患者术后恢复, 减少并发症的发生。

    关键词胃肿瘤;营养支持

    AbstractObjective: To evaluate the role of nutritional support in the patients with gastrointestinal neoplasms on nutritional status after surgical procedure.Methods:Totally 49 patients with gastrointestinal carcinoma and malnutrition were involved in this study.The patients were randomly assigned to receive early postoperative enteral nutrition for 2 to 7 d(group)or total parenteral nutrition support after operation for 1 to 7 d (total parental nutrition group).The nutrition status ,cellular and humoral immunity of the patients was detected before and after operation.Results :Cellular immunity indexes better than the TPN group, humoral immunity were no significant differences. The serum level of TSP,albumin, transferrin of enteral nutrition and total parental nutrition groups postoperatively decreased as compared with that before operation,but with no difference postoperatively between the two groups.In the control group,the postoperative selum level of total protein albumin and transferrin decreased significantly(P<0.05)as compared to the preoperative leve1.The occurrence of postoperative complications and hospital stay of the enteral nutrition group and the total parental nutrition group were less than that of the control group.Conclusion :The present study suggests that early enteral nutrition support can improve the patients’ nutritional status,reduce the incidence of postoperative complications and hospital stay. ......