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目的:比较不同营养支持途径对胃癌和结直肠癌病人术后指标的影响。方法:将120例胃癌和结直肠癌根治术后病人,随机分为EEN组、PN组和对照组(传统营养)三组,每组40例。EEN组和PN组于术后第1和第2天给予1/3、2/3目标量。第3至第8天维持目标量,两组病人基本等氮、等热量。对照组按传统做法给予禁食、流质和半流质。于手术前1天和术后第9天检测病人血清ALB、TF、PA、CD3、CD4、CD4/CD8,记录营养支持不良反应的发生率、胃肠道功能恢复时间、感染性并发症的发生率、营养支持费用和感染性并发症的治疗费用。结果:手术前1天EEN组、PN组和对照组营养指标、免疫指标水平无显著性差异。术后第9天EEN组和PN组的营养指标、免疫指标水平均优于对照组(P<0.01)。EEN组和PN组的营养指标无显著性差异(P>0.05),但EEN组的免疫指标高于PN组(P<0.05)。EEN组和PN组营养支持不良反应的发生率无显著性差异(P>0.05)。EEN组胃肠道功能恢复时间早于PN组和对照组(P<0.01)。EEN组感染性并发症的发生率低于PN组(P<0.05),EEN组营养支持费用和感染性并发症治疗费用均少于PN组(P<0.01)。对照组的营养支持费用最少,但其感染性并发症的发生率最高,感染性并发症治疗费用亦最多。结论:对胃癌和结直肠癌病人术后营养支持的方案应首选EEN,其次为PN。
Objective: To compare the effect of different nutrition support ways on postoperative indexes of gastric cancer and colorectal cancer patients. Methods: 120 patients with gastric cancer and colorectal cancer after radical operation were randomly divided into EEN group, PN group and control group (traditional nutrition) three groups, 40 cases in each group. EEN group and PN group were given 1 / 3,2 / 3 target volume on the 1st and 2nd postoperative day. The third to the eighth day to maintain the target amount of basic nitrogen and other two groups of patients, and other calories. The control group was given fasting, liquid and semi-liquid according to the traditional method. Serum ALB, TF, PA, CD3, CD4, CD4 / CD8 were measured at 1 day before surgery and 9 days after operation. The incidence of adverse reactions of nutrition support, recovery time of gastrointestinal function and infectious complications were recorded Rates, nutritional support costs and infectious complications of treatment costs. Results: One day before surgery, there were no significant differences in the levels of nutritional indicators and immune indicators between EEN group, PN group and control group. On the 9th day after operation, the nutritional indexes and immunological indexes of EEN group and PN group were better than those of the control group (P <0.01). There was no significant difference in nutritional indices between EEN group and PN group (P> 0.05), but the immune index of EEN group was higher than that of PN group (P <0.05). There was no significant difference in the incidence of nutritional support adverse reactions between EEN group and PN group (P> 0.05). Gastrointestinal function recovery time in EEN group was earlier than that in PN group and control group (P <0.01). The incidence of infectious complications in EEN group was lower than that in PN group (P <0.05). The nutritional support costs and infectious complications in EEN group were less than those in PN group (P <0.01). The control group had the least nutritional support but had the highest incidence of infectious complications and the highest cost of infectious complications. Conclusion: EEN should be the first choice for postoperative nutrition support for patients with gastric cancer and colorectal cancer, followed by PN.