[1]汪新有,翁延宏,陈伟.胃癌根治术后早期肠内营养的应用探讨[J].肠外与肠内营养杂志,2021,(04):216-219.[doi:10.16151/j.1007-810x.2021.04.006]
　WANG Xin-you,WENG Yan-hong,CHEN Wei.Application of early enteral nutrition after radical resection of gastric cancer[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):216-219.[doi:10.16151/j.1007-810x.2021.04.006]
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胃癌根治术后早期肠内营养的应用探讨
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2021年04期
页码:
216-219
栏目:
论著
出版日期:
2021-07-10

文章信息/Info

Title:
Application of early enteral nutrition after radical resection of gastric cancer
作者:
汪新有; 翁延宏; 陈伟
安徽省黄山首康医院普通外科，安徽黄山 245000
Author(s):
WANG Xin-you;  WENG Yan-hong;  CHEN Wei
Department of General Surgery, Huangshan Shoukang Hospital, Huangshan 245000, Anhui, China
关键词:
早期肠内营养 ; 营养治疗 ; 胃癌 ; 腹腔镜
Keywords:
Early enteral nutrition;  Nutrition therapy;  Gastric cancer;  Laparoscope
分类号:
R459.3，R45
DOI:
10.16151/j.1007-810x.2021.04.006
文献标志码:
A
摘要:
目的：观察腹腔镜下胃癌根治术后早期肠内营养的安全性及耐受性，以期为胃癌根治术后营养治疗的开展提供参考。方法：前瞻性收集2019年1月至2020年12月在安徽省黄山首康医院普通外科接受腹腔镜下胃癌根治术的病人，随机分为观察组和对照组。2组在术后7 d接受不同的营养治疗方式，观察组于术后24 h内开始鼻饲肠内营养，逐步过渡至口服肠内营养；对照组则在术后早期接受肠外营养，待肠功能恢复后逐步过渡至口服肠内营养。比较2组并发症、进食耐受性、营养状况、肠功能恢复情况、住院时间及住院费用等，并随访至术后第6个月。结果：本研究共纳入60例胃癌病人（观察组30例，对照组30例），均治愈出院。2组病人的基线资料差异无统计学意义（P > 0.05）。观察组发生肠梗阻2例(2/30, 6.7%)；对照组发生肺部感染1例、肠梗阻2例(3/30, 10.0%)，观察组总体并发症发生率与对照组比较差异无统计学意义(P > 0.05)。观察组2例出现恶心伴呕吐、腹胀等进食不耐受情况，予以暂停肠内营养并经肠外营养及保守治疗后缓解。两组间进食不耐受的差异无统计学意义(P > 0.05)。观察组术后第3天血清白蛋白、前白蛋白的水平明显高于对照组（P < 0.05）。观察组术后首次排气时间短、留置引流管时间短、术后住院时间短、住院总费用少(P < 0. 05)。两组均随访6个月，无死亡病例，未发生远期并发症及肿 瘤复发。结论：腹腔镜胃癌根治术后早期开展鼻饲肠内营养并逐步过渡至口服肠内营养不增加并发症发生率，且可促进术后胃肠功能的恢复，缩短住院时间，安全可行。
Abstract:
Objective: To observe the safety and tolerability of early enteral nutrition after laparoscopic radical gastrectomy, in order to provide reference for the development of nutritional treatment after radical gastrectomy. Methods: Patients who received laparoscopic radical gastrectomy in our hospital from January 2019 to December 2020 were prospectively collected and randomly divided into observation group and control group. The two groups received different nutritional treatment during the first 7 days after surgery. Patients in the observation group received enteral nutrition by nasal feeding within 24 hours after surgery, and gradually transitioned to complete oral enteral nutrition. For the patients in the control group, total parenteral nutrition was given during the early postoperative period, and after the recovery of intestinal function, it was gradually transferred to complete oral enteral nutrition. The nutritional status, food tolerance, complications, postoperative hospitalization time and postoperative hospitalization cost of patients in the two groups after laparoscopic radical gastrectomy were observed and analyzed. All patients needed to be followed up for at least 6 months. Results: A total of 60 patients with gastric cancer were included in this study, including 30 patients in the observation group and 30 patients in the control group. All patients in the two groups were cured and discharged without death. There was no statistical significance in the baseline information (sex, age, TNM stage, pathological classification, serum albumin, and pre-albumin) between the two groups (P > 0.05）. In the observation group, intestinal obstruction occurred in 2 cases (2/30, 6.7%); in the control group, there was 1 case of pulmonary infection and 2 cases of intestinal obstruction (3/30, 10.0%). There was no significant difference in the overall incidence of complications between the observation group and the control group (P > 0.05). In the observation group, there were 2 cases of nausea with vomiting and abdominal distension, who were suspended enteral nutrition and relieved by parenteral nutrition and conservative treatment. There was no significant difference between groups (P > 0.05) on the incidence of intolerance. The levels of serum albumin, and pre-albumin of the observation group were significantly higher than that of control group at the 3rd day postoperatively（P < 0.05）. There were shorter interval periods of postoperative exhaust time, shorter periods of drainage placement, shorter postoperative hospital stays, and less hospitalization cost in the observation group than those in the control group (P < 0. 05). All patients were followed up for 6 months. There was no death, no long-term complications, and no recurrence. Conclusions: The early implementation of nasal feeding enteral nutrition and the gradual transition to oral enteral nutrition after laparoscopic radical gastrectomy for gastric cancer does not increase the incidence of complications, and can promote the recovery of postoperative gastrointestinal function and shorten the duration of hospital stay, which is safe and feasible.

参考文献/References:


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备注/Memo

备注/Memo:
作者简介 ：汪新有，主治医师，医学本科，主要从事胃肠道肿瘤疾病诊治。E-mail：2375586360@qq.com 通讯作者 ：翁延宏，E-mail：hsskwyh@sina.com
更新日期/Last Update: 1900-01-01