Objective To investigate the effects on the condition of nutrition and immunologic function of gastric cancer treated with the insertion of jejunal nutrient canal after total gastrectomy.Methods In this study 113 gastric cancer patients were randomly divided into enteral nutrition group (the group of the fine-needle/catheter jejunostomy during operation,FCJ group) and parenteral nutrition group (PN group) after total gastrectomy.Evacuating time and postoperative complications were observed and relative laboratory parameters were measured prior to surgery (preoperative) and on days 3 and 7 postoperatively.Results The evacuating time in enteral nutrition group was shorter than that in parenteral nutrition group significantly[(4.1±2.2) d vs.(5.1 ±2.0) d,t =2.156,P =0.037];Serum level of prealbumin[( 18 ± 7 ) mg/dl vs.( 14 ± 7 ) mg/dl,t =2.370,P =0.022]and transferring[(205 ±45 ) mg/dl vs.( 186 ± 39 ) mg/dl,t =3.665,P =0.001]in enteral nutrition group on postoperative day 7 was higher than that in parenteral nutrition group;Serum IgA[( 2.3 ± 1.0 ) g/L vs.( 1.9 + 0.7 ) g/L,t =2.178,P=0.034],lgM[(1.4 ±0.4) g/L vs.(1.0 ±0.4) g/L,t=2.124,P=0.039]and IgG[(9.5 ±1.9) g/L vs.(9.0 ± 2.3 ) g/L,t =2.189,P =0.033]were higher in enteral nutrition group than that in parenteral nutrition group;The incidence of postoperative alimentary dysfunction in enteral nutrition group was lower than that in parenteral nutrition group( 3％ vs.13％,x2 =3.962,P =0.048).Conclusions It is safe and convenient to use early postoperative enteral nutrition support by fine-needle/catheter jejunostomy (FCJ) in gastric cancer patients immediately after total gastrectomy.%目的 探讨术中经皮空肠营养置管早期肠内营养对全胃切除胃癌患者的营养状态及免疫功能的影响.方法 将113例胃癌患者随机分成两组,术中空肠营养管置入肠内营养组(66例)和肠外营养支持组(47例).两组均行全胃切除术,术后分别接受7d同等条件的营养支持,比较两组排气时间、并发症发生率,检测两组患者术前和术后3、7d有关的实验室指标.结果 肠内营养组的肛门排气时间明显短于肠外营养组[(4.1±2.2)d比(5.1±2.0)d,t=2.156,P=0.037]；肠内营养组与肠外营养组相比,术后7d血清前白蛋白显著增高[(18±7)mg/dl比(14±7) mg/dl,t=2.370,P=0.022]、转铁蛋白水平明显增高[(205±45)mg/dl比(186±39) mg/dl,t=3.665,P=0.001];术后7d肠内营养组与肠外营养组相比,血清IgA[(2.3±1.0) g/L比(1.9±0.7) g/L,t=2.178,P=0.034]、IgM[(1.4±0.4) g/L比(1.0±0.4) g/L,t =2.124,P=0.039]、IgG[(9.5±1.9) g/L比(9.0±2.3) g/L,t =2.189,p=0.033]均显著增高；术后肠内营养组消化道功能障碍发生率低于肠外组(3％比13％,x2=3.962,P=0.048).结论 胃癌全胃切除术患者术中经皮穿刺空肠营养管置入予以术后早期肠内营养安全方便,营养状态及免疫水平改善均优于肠外营养.
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