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目的：研究胃癌病人围手术期营养支持的临床疗效以及肠内、肠外营养方式的优缺点。方法：将３４例胃癌病人随机分为肠内营养（ｅｎｔｅｒａｌｎｕｔｒｉｔｉｏｎ，ＥＮ组）和肠外营养（ｐａｒｅｎｔｅｒａｌｎｕｔｒｉｔｉｏｎ，ＰＮ组）两组，每组１７例。围手术期给予等热量等氮量的营养支持，术前进行７～１０天的营养支持，术后３～１０天经不同途径进行营养支持。结果：术后１０天两组血清转铁蛋白（ＴＦ）、前白蛋白（ｐｒｅａｌｂ）、纤维连接蛋白（ＦＮ）水平均显著提高（Ｐ＜０．０５或Ｐ＜０．０１），术后１０天ＰＮ组Ｐｒｅａｌｂ、ＦＮ水平显著高于ＥＮ组（Ｐ＜０．０１）；而ＥＮ组肠功能恢复早于ＰＮ组，住院时间和营养费用少于ＰＮ组。结论：伴有严重营养不良的胃癌患者，围手术期营养支持能改善病人营养状况，ＰＮ优于ＥＮ，而ＥＮ有利于肠功能恢复，可减少营养费用和住院日
Objective: To study the clinical efficacy of perioperative nutritional support and the advantages and disadvantages of enteral and parenteral nutrition in patients with gastric cancer. METHODS: Thirty-four patients with gastric cancer were randomly divided into two groups: enteral nutrition (EN group) and parenteral nutrition (PN group), 17 cases in each group. During the perioperative period, nutritional support such as equal amount of heat and nitrogen was given. Nutrient support was performed for 7 to 10 days before operation, and nutritional support was given by different ways 3 to 10 days after surgery. Results: The serum levels of transferrin (TF), prealb, and fibronectin (FN) increased significantly (P<0.05 or P<0.01) in both groups 10 days after surgery. The level of Prealb and FN in the PN group was significantly higher than that in the EN group (P<0.01). In the EN group, the intestinal function recovery was earlier than that in the PN group, and the length of hospital stay and nutrition were less than those in the PN group. Conclusion: Perioperative nutritional support can improve the nutritional status of patients with severe malnutrition in gastric cancer. PN is superior to EN, and EN is beneficial to intestinal function recovery, which can reduce nutritional costs and hospitalization days.