摘要
目的探讨肠内营养支持对根治性胃癌术后胃肠功能、营养状态和应激炎性反应的影响。方法 2017年1月~2020年1月间行根治性胃癌术老年胃癌病人98例,依据随机数字表法随机分为观察组和对照组,每组各49例。观察组采用肠内营养支持治疗,对照组采用肠外营养支持治疗。比较两组排气时间、肠鸣音时间和排便时间,术前、术后1天和术后7天营养状态和肠道菌群变化,及术后1天和术后7天应激反应变化。结果观察组排气时间、肠鸣音时间和排便时间快于对照组,差异有统计学意义(P<0.05)。观察组术后7天血清白蛋白和前白蛋白水平高于对照组,差异有统计学意义(P<0.05)。观察组术后7天双歧杆菌多于对照组,而肠球菌和大肠杆菌少于对照组,差异有统计学意义(P<0.05)。观察组术后7天血清C反应蛋白、白细胞介素-6和皮质醇水平低于对照组,差异有统计学意义(P<0.05)。结论肠内营养支持对根治性胃癌术后病人效果明显,可改善病人胃肠功能,改善营养状态,纠正肠道菌群紊乱,减轻应激反应。
Objective To explore the effect of enteral nutrition support on gastrointestinal function, nutritional status and stress inflammatory response with gastric cancer after radical operation.Methods The 98 patients with gastric cancer who underwent radical gastrectomy in our hospital from January 2017 to January 2020 were randomly divided into observation group(49 cases) and control group(49 cases).The observation group was treated with enteral nutrition support, while the control group was treated with parenteral nutrition support.The exhaust time, bowel sound time, defecation time, preoperative, postoperative 1 day and 7 days after the changes of nutritional status and intestinal flora, and postoperative 1 day and 7 days after the changes of stress response were compared between the two groups.Results The exhaust time, bowel sound time and defecation time of the observation group were faster than those of the control group(P<0.05).After postoperative 7 d, the observation group level of ALB and PA was higher control group(P<0.05).After postoperative 7 d, the observation group number of bifidobacteria was more control group, while that in the Enterococcus and Escherichia coli postoperative 7 d was less control group(P<0.05).After postoperative 7 d, the observation group levels of CRP,IL-6 and Cor in the observation group postoperative 7 d were lower control group(P<0.05).Conclusion Enteral nutrition support has obvious effect with gastric cancer after operation, which can significantly improve the gastrointestinal function, improve the nutritional status of the patients, correct the intestinal flora disorder and reduce the stress response.
作者
彭启旺
邓浩
PENG Qiwang;DENG Hao(Department of General Surgery,Wuhan Red Cross Hospital,Wuhan 430021,China)
出处
《临床外科杂志》
2021年第5期445-448,共4页
Journal of Clinical Surgery
关键词
肠内营养支持
老年胃癌
营养状态
肠道菌群
应激反应
enteral nutrition support
elderly gastric cancer
nutritional status
intestinal flora
stress response
