Objective To study the therapeutic effect of enteral nutrition (EN) combined with somatostatin in treating patients during perioperative period of gastrectomy and to reduce postoperative complications and prompt recovery. Method 237 patients with advanced gastric cancer received gastrectomy and nutritional risk screening 2002 (NRS 2002) score higher than 3 points admitted to our hospital from Feburary 2013 to Feburary 2016 were enrolled in this study. Patients were randomly divided into combined treatment group (n = 97), nutritional support group (n = 88) and control group (n = 52). Combined treatment group and thenutritional support group were given EN for 1 week before surgery, and combined treatment group patients were given somatostatin 24 hours before surgery. The levels of serum albumin (ALB), prealbumin (PA), and amylase in the serum were test at admission, the 1st, 3rd and 7th days after surgery. The level of amylase in drained fluid was at the 1st, 3rd and 7th days after surgery. The volume of the drained fluid and the time to extubation were recorded. The complications such as bleed, fistula, intestinal obstruction and infection were compared among three groups. Result There were no differences in the level of serum ALB among three groups at each time point after surgery (P > 0.05). The serum PA level in combined treatment group was significantly higher than nutritional support group at the same time points after surgery (P < 0.05), Compared with control group at the same time points, the level of serum PA of combined treatment grop and nutritional support group were significantly higher (P < 0.05). The levels of serum amylase in three groups at each time point after surgery were significantly higher than that at admission (P < 0.05). The level of serum amylase in combined treatment group at 1st day after surgery was significantly lower than the other two groups (P<0.05), and the level of drained amylase was significantly lower than control group at the same time points (P<0.05). The volume of the drained fluid of combined treatment group significantly decreased compared with nutritional support group (P < 0.05), and both groups were significantly lower than control group (P < 0.05). The time to extubation of combined treatment group and nutritional support group had no significantly difference (P > 0.05), but were significantly shorter than control group (P < 0.05). Compared with control group, the complications including infection and the intestinal obstruction rates were significantly decreased in combined treatment group and nutritional support group (P < 0.05). Conclusion Nutritional support and somatostatin can be useful in gastric patients with nutritional risk to improve the nutritional status, abbreviate pancreas damage and decrease the accidence of complications before surgery.%目的 研究围术期肠内营养支持联合应用生长抑素对胃癌根治术患者的治疗作用,为减少手术并发症,促进患者早日康复提供依据.方法 选取2013年2月至2016年2月于本院行胃癌根治术治疗的237例营养风险筛查量表2002(nutritional risk screening 2002,NRS 2002)评分≥3分的患者为研究对象,将其随机分为联合治疗组(97例)、营养支持组(88例)及对照组(52例).联合治疗组和营养支持组患者术前给予为期1周的肠内营养支持,联合治疗组患者术前24小时给予生长抑素.入院时、术后第1、3、7天检测患者血清白蛋白(albumin,ALB)、前白蛋白(prealbumin,PA)及血清淀粉酶水平;检测术后各时间点腹腔引流液中淀粉酶水平;记录患者术后引流量和引流管拔除时间;比较患者术后出血、吻合口瘘、胰瘘、肠梗阻、感染等并发症发生情况.结果 三组患者术后第1、3、7天血清ALB水平比较均无显著差异(P>0.05);联合治疗组患者术后第1、3、7天血清PA水平显著高于营养支持组同时间点水平(P<0.05),联合治疗组和营养支持组患者术后上述各时间点血清PA水平均较本组入院时及对照组同时间点显著升高(P<0.05).三组患者术后上述各时间点血清淀粉酶水平较入院时均显著升高(P<0.05);联合治疗组患者术后第1天血清淀粉酶水平显著低于营养支持组和对照组同时间点水平(P<0.05),术后第1天引流液中淀粉酶水平显著低于对照组同时间点水平(P<0.05);联合治疗组患者术后引流量显著少于营养支持组(P<0.05),两组均显著少于对照组(P<0.05);联合治疗组与营养支持组患者引流时间比较无显著差异(P>0.05),但均显著短于对照组(P<0.05).联合治疗组和营养支持组患者感染(切口及其他部位)、肠梗阻发生率均显著低于对照组(P<0.05).结论 胃癌根治术前对存在营养风险的患者进行肠内营养支持联合使用生长抑素,可以改善患者营养状况,减轻胰腺损伤,减少并发症的发生.
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