CAJ | 학술논문

对40例经腹行近端胃切除术治疗的胃上部癌患者术后均给予肠外营养,待肠功能恢复后逐步过渡为全量肠内营养,观察术前及术后第1、8天血白蛋白、前白蛋白、转铁蛋白等营养学指标及IgA、IgG、IgM、C3、G4等免疫学指标.平均住院时间14 d,肛门排气时间平均(58±6)h.术前、术后血生化及肝肾功能指标无显著改变(P＞0.05);术后第1天营养指标及免疫指标与术前比较差异有统计学意义(P＜0.05),除IgM术前与术后第1天、IgG术前与术后第8天比较差异无统计学意义外,其他差异均有统计学意义(P＜0.05).3例(8%)并发症中:膈下感染1例,吻合口瘘2例,经保守治疗后痊愈出院.提示,近端胃切除术后肠内外联合营养支持可改善患者的营养及免疫状态.
대40례경복행근단위절제술치료적위상부암환자술후균급여장외영양,대장공능회복후축보과도위전량장내영양,관찰술전급술후제1、8천혈백단백、전백단백、전철단백등영양학지표급IgA、IgG、IgM、C3、G4등면역학지표.평균주원시간14 d,항문배기시간평균(58±6)h.술전、술후혈생화급간신공능지표무현저개변(P＞0.05);술후제1천영양지표급면역지표여술전비교차이유통계학의의(P＜0.05),제IgM술전여술후제1천、IgG술전여술후제8천비교차이무통계학의의외,기타차이균유통계학의의(P＜0.05).3례(8%)병발증중:격하감염1례,문합구루2례,경보수치료후전유출원.제시,근단위절제술후장내외연합영양지지가개선환자적영양급면역상태.
Parenteral nutrition (PN) was given to 40 patients with upper gastric carcinoma after proximal gastrectomies; and full enteral nutrition (EN) was subsequently given when bowels function recovered.The nutritional indicators including serum albumin ( Alb),prealbumin .(PA) and transferring,and immunological indicators including IgA,IgG,IgM,C3,C4 were measured before and 1st,8th day after operation.The data were processed by software SPSS 13.0.The average length of hospital stay was 14 d and the aerofluxus time was (58 ±6)hours.There were no changes in blood biochemistry,hepatic function and renal function pre- and post-operation( P ＞0.05 ).The nutritional and immune indicators except the IgM in 1 st day after operation were decreased significantly ( P ＜ 0.05 ).The immune indicators except the IgG in 8th day after operation were significantly improved in comparison of those before and 1st day after operation ( P ＜ 0.05 ).Post-operative complications occurred in 3 patients including 1 case of subphrenic infection and 2 cases of anastomotic leakage.After proper treatment,all patients recovered well.Combined application of EN and PN may improve nutrition and immune status of patients after proximal gastrectomy.