早期肠内营养与全肠外营养对胃癌合并糖尿病患者术后恢复情况的影响对比

摘要

Objective To investigate the influence on postoperative recovery of early enteral nutrition (EEN) and total parenteral nutrition (TPN) in patients with diabetes undergoing gastrectomy for gastric cancer.Methods 76 patients with diabetes undergoing gastrectomy for gastric cancer in our hospital from February 2012 to July 2012 were divided into EEN group and TPN group according to the different methods of nutritional support,EEN group was treated with EEN,and TPN group was treated with TPN,the liver function,nutritional indexes,the change of blood glucose,gastrointestinal recovery and the complications of two groups in different time were compared.Results The liver function and nutritional indexes of EEN group on the fourth day were much higher than those in TPN group,the difference was statistically significant (P ＜ 0.05).8 days after operation the blood glucose fluctuation values of TPN group was larger compared with that of the EEN group,and the fluctuation value was higher than that of EEN group,the difference was statistically significant (P ＜ 0.05).Anal exhaust time of EEN group was much lower than that of TPN group,the difference was statistically significant (P ＜ 0.05).EEN group had no complications,the complication rate was far lower than that in TPN group,the difference was statistically significant (P ＜ 0.05).Conclusion Taking EEN in gastric cancer patients complicated with diabetes as postoperative nutritional support can improve the nutritional status of patients,not only can keep blood sugar stable,but also has a lower incidence of postoperative complications,which can promote the rehabilitation of patients with good effect on the body.%目的 探讨早期肠内营养(EEN)与全肠外营养(TPN)对胃癌合并糖尿病患者术后恢复情况的影响.方法 将我院2011年1月至2013年7月收治的76例胃癌合并糖尿病术后患者按不同营养支持方法分为EEN组和TPN组,EEN组采用早期肠内营养法,TPN组采用全肠外营养法,比较两组患者术后不同时间肝功能以及营养指标、血糖变化、胃肠道恢复情况以及并发症情况.结果 术后第4 d EEN组肝功能以及各项营养指标的恢复水平均远高于TPN组,差异有统计学意义(P＜0.05).术后8d内TPN组患者血糖波动水平较EEN组大,且波动值高于EEN组,差异有统计学意义(P＜0.05).EEN组肛门排气时间远低于TPN组,差异有统计学意义(P＜0.05);EEN组无一例并发症,并发症发生率远低于TPN组,差异有统计学意义(P＜0.05).结论 采用早期肠内营养对胃癌合并糖尿病术后患者进行营养支持可有效改善患者营养状况,不仅能维持血糖平稳,也能降低术后并发症发生率,对促进患者身体恢复具有良好作用.