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1、早期肠外营养与肠内营养在全胃切除术屮的疗效观察［摘要］目的探讨全胃切除术早期肠外营养与肠内营养的疗效。方法将86例因胃癌行全胃切除术的患者随机分为早期肠外营养组与肠内营养纟R,每纟R43例。观察两组患者免疫功能状况指标、并发症发生率及术后肠道功能恢父时间和平均住院时间。结果肠内营养组TLC、TRF、CD4、CD8营养后均较肠外营养组明显升高，两组比较有显著性差异(卩均<0.05)；两组Alb、IgG、IgM、C3营养后均较营养前有所提高，但营养前示比较无显著性差异(P>0.05)o肠内营养纟R腹泻、腹涨、恶心等不良反应的发生率为23.3%,较肠
2、外营养纟R的37.2%低(P<0.05)。肠内营养组术麻肠道功能恢复时间、平均住院时间均低于肠外营养纟ft(P均V0.05)。结论全胃切除术后早期肠内营养是安全、有效的营养支持途径，可迅速恢复患者的免疫状态,缩短肠道功能恢复时间和住院时间。［关键词］全胃切除术；肠外营养；肠内营养；胃癌［中图分类号］R459.3；R735.2［文献标识码］B［文章编号］1673-9701(2011)26-159-02EfficacyofEarlyParenteralNutritionandEntera!NutritioninTotalGastreetomyLIN
3、MuqingJIANGSipingYUQiangYANGYanqingIIUZhenghuaMAOJinshuiTheFirstDepartmentofSurgery,ChangshanCountyPeople'sHospital,Changshan324200,China［Abstract］ObjectiveToevaluatetheefficacyofearlyparentera!nutritionandenteralnutritioninthepatientsoftotalgastrectomy.MethodsEighty-sixpati
4、entswithtotalgastrectomyforgastriccancersurgerywererandomlydividedintogroupsofearlyparent.eralnutritionandenteralnutritiongroup,43patientsineachgroup.Immunefunctionindex,complicationrateandpostoperativeintestinalfunctionrecoverytimeandaveragehospitalstaywereobserved.ResuItsT
5、heTLC,TRF,CD4,CD8afternutrientsinenteralnutritiongroupwassignifiedntlyhigherthanthatintheparenteralnutritionrespectivly(P<0.05).Alb,IgG,IgM,C3nutritionincreasedafterniMrition,buttherewasnosignificantdifferencebetweenafterandbeforenuriLion(P>0・05)・Adversereactionsincludingdia
6、rrhea,abdominaldistention,nauseaetcintheenteralnutritiongroupwas23.3%,lowerthanthatoftheparenteralnutritiongroup(37.2%)(P<0.05).Intestinalfunctionrecoverytime,meanhospitalstayintheenteralnutritionwerelowerthanintheparenteralnutrit.iongrouprespectivly(P<0・05).ConclusionEarlye
7、nteralnutritionaftergastrectomyissafe,effectivenutritionalsupportavenucsforrapidrecoveryoftheimmunestatusofpatientsandcanshortenthetimeofbowelfunctionrecoveryandhospitalstay・［Keywords］Totalgastrectomy；Parenteralnutrition；Enteralnutrition；Gastriccancer全胃切除术是治疗胃癌的主要术式之一，全胃切除术后
8、机体以分解代谢为主，处于高代谢状态，充分的营养支持包括给予足够的热能、蛋H质、电解质和维生素等是尽早使机体恢复、减少术示并发症的主要手段［1,2］。我
