论文部分内容阅读
目的:探讨早期肠内及肠外营养支持对老年胃癌术后的运用,为改善患者的预后提供临床指导。方法:选取我院2008年2月~2014年2月收治的152例老年胃癌患者,分别纳入肠内营养(Enteral nutrition,EN)组(51例)、肠外营养(Parenteral nutrition,PN)组(51例)及EN联合PN组(50例),比较各组患者术后并发症、营养指标、血清指标及住院情况等,分析老年胃癌术后的最佳营养支持方案。结果:EN组胃肠道功能恢复时间为(46.3±5.2)h,PN组为(51.4±7.3)h,EN联合PN组为(41.9±4.4)h,EN联合PN组胃肠道功能恢复时间显著低于其他两组(P<0.05);三组患者术后白蛋白、转铁蛋白、前白蛋白及CD8测定值无明显统计学差异(P>0.05),EN联合PN组血清C反应蛋白、CD4显著低于其他两组,CD3和CD4/CD8显著高于其他两组(P<0.05);EN联合PN组感染性并发症发生率及住院时间均显著低于其他两组(P<0.05),其治疗费用介于EN组和PN组之间。结论:肠内联合肠外序贯营养支持较单纯肠内营养或肠外营养支持具有高效、合理、经济、安全等多种优势,能够促进患者消化吸收功能的恢复,改善老年胃癌患者预后和生存质量,值得各级医院推广应用。
Objective: To explore the use of early enteral and parenteral nutrition support for postoperative elderly patients with gastric cancer and to provide clinical guidance to improve the prognosis of patients. Methods: A total of 152 elderly patients with gastric cancer admitted to our hospital from February 2008 to February 2014 were enrolled in this study. Enteral nutrition group (n = 51), parenteral nutrition group (n = 51 cases) and EN combined with PN group (50 cases). The postoperative complications, nutritional indices, serum indexes and hospitalization were compared between the two groups to analyze the optimal nutritional support for elderly patients with gastric cancer. Results: The recovery time of gastrointestinal function was (46.3 ± 5.2) h in EN group, (51.4 ± 7.3) h in PN group and (41.9 ± 4.4) h in EN group and PN group (P <0.05). The postoperative albumin, transferrin, prealbumin and CD8 in the three groups had no significant difference (P> 0.05). The levels of serum C-reactive protein , CD4 was significantly lower than the other two groups, CD3 and CD4 / CD8 was significantly higher than the other two groups (P <0.05); EN combined with PN incidence of infectious complications and hospital stay were significantly lower than the other two groups (P <0.05 ), The cost of treatment between the EN group and PN group. Conclusion: Enteral parenteral sequential nutrition support is more efficient, rational, economical and safe than simple enteral nutrition or parenteral nutrition support, which can promote the recovery of digestion and absorption and improve the prognosis and survival of elderly patients with gastric cancer Quality, it is worth to promote the use of hospitals at all levels.