CAJ | 학술논문

目的：探讨胃癌根治术后分别实施早期肠内营养与肠外营养的临床效果，为胃癌患者术后提供更好的营养支持治疗。方法：回顾性分析本院2009年2月至2011年2月收治的接受胃癌根治术后行肠内营养及肠外营养患者各70例，其中肠外营养组给予常规肠外静脉营养治疗，肠内营养组在术后第1～5天给予肠内营养剂，观察患者术后第1天和第7天血清白蛋白、血红蛋白、丙氨酸转氨酶、天冬氨酸转氨酶水平，及血液中IgA、IgG、IgM和CD4+细胞、NK细胞、B淋巴细胞情况。结果：肠内营养组术后第1天和第7天血清白蛋白、血红蛋白、丙氨酸转氨酶、天冬氨酸转氨酶水平显著优于肠外营养组，差异有统计学意义（P<0.05）；同时肠内营养组患者术后第7天与术后第1天及肠外营养组术后第8天比较，IgA、IgG、IgM和CD4+细胞、NK细胞、B淋巴细胞显著升高，差异有统计学意义（P<0.05）。结论：胃癌患者术后早期肠内营养可有效改善术后营养水平，以及免疫相关指标，具有临床使用价值。
목적：탐토위암근치술후분별실시조기장내영양여장외영양적림상효과，위위암환자술후제공경호적영양지지치료。방법：회고성분석본원2009년2월지2011년2월수치적접수위암근치술후행장내영양급장외영양환자각70례，기중장외영양조급여상규장외정맥영양치료，장내영양조재술후제1～5천급여장내영양제，관찰환자술후제1천화제7천혈청백단백、혈홍단백、병안산전안매、천동안산전안매수평，급혈액중IgA、IgG、IgM화CD4+세포、NK세포、B림파세포정황。결과：장내영양조술후제1천화제7천혈청백단백、혈홍단백、병안산전안매、천동안산전안매수평현저우우장외영양조，차이유통계학의의（P<0.05）；동시장내영양조환자술후제7천여술후제1천급장외영양조술후제8천비교，IgA、IgG、IgM화CD4+세포、NK세포、B림파세포현저승고，차이유통계학의의（P<0.05）。결론：위암환자술후조기장내영양가유효개선술후영양수평，이급면역상관지표，구유림상사용개치。
Objective:To study the clinical effect of early postoperative enteral nutrition and parenteral nutrition after radical ex-cision of gastric cancer to provide a better way of treating gastric cancers. Methods:Retrospective analysis of 140 gastric cancer pa-tients who were admitted to the PLA General Hospital between February 2009 and February 2011 was conducted. These patients were randomized into two groups based on the clinical trial, i.e., 70 in the control group received an intravenous parenteral nutrition for the treatment, and for the other 70 in the observation group, jejunostomy was done 1 to 5 days after the radical surgery by using Supportan as the enteral nutritional agent with a dose of at TPF-T 500 mL/d to 1 000 mL/d. The postoperative long-term survival rate of the pa-tients, the serum albumin, hemoglobin, alanine aminotransferase, aspartate aminotransferase levels before and after the treatment, as well as the situation of IgA, IgG, IgM and CD4+cells, NK cells, and B lymphocytes in the blood at the first and the seventh day after surgery were observed in the patients. Results:After the implementation of early enteral nutrition in the observation group, the 1-and 3-year survival rates were 84.29% (59/70) and 61.43% (43/70) respectively, whereas in the control group, the survival rates were 64.29% (45/70) and 47.143% (33/70) respectively, with statistically significant differences between the two groups (P<0.05). At the first and seventh day after surgery, the serum albumin, hemoglobin, alanine aminotransferase, and aspartate aminotransferase levels were significantly better in the observation group than in the control group, with statistically significant differences between the two (P<0.05). Compared with the parameters in the observation group at the first day after surgery and those in the control groups at the eighth day after surgery, the levels of IgA , IgG, IgM and CD42+cells, NK cells, and B lymphocytes were significantly increased in the obser-vation group at the seventh day after surgery. The differences among them were statistically significant (P<0.05). Conclusion: Early postoperative enteral nutrition for the gastric cancer patients undergoing radical surgery can be effective in improving the nutrition level of the patients and in enhancing their long-term survival rate, Thus, the treatment has value in clinical application.