CAJ | 학술논문

目的：探讨腹腔镜根治性全胃切除术、开腹根治性全胃切除术后早期肠内营养支持效果和肠功能恢复情况，并观察临床安全性。方法2012年1月至2013年8月在我院住院治疗的38例胃中、上部恶性肿瘤患者，随机分为开腹手术组、腹腔镜手术组，每组19例。所有患者于术后12 h 给予同样肠内营养并逐量增加，共用6 d，前4 d 同时给予肠外营养。观察患者肠功能恢复时间、消化道症状，总蛋白（TP）、白蛋白（ALB）和前白蛋白（PA）水平以及各种相关并发症发生率等。结果腹腔镜手术组较开腹手术组术后肠功能恢复时间显著提前（P ＜0.01），腹腔镜手术组营养支持后白蛋白、前白蛋白显著高于开腹手术组（均 P ＜0.01）。结论根治性全胃切除术后患者接受早期肠内营养支持，有利于营养状况恢复，该营养途径安全、合理。因此，早期肠内营养治疗支持下腹腔镜根治性全胃切除术患者营养状况、肠功能恢复较开腹手术优势明显。
목적：탐토복강경근치성전위절제술、개복근치성전위절제술후조기장내영양지지효과화장공능회복정황，병관찰림상안전성。방법2012년1월지2013년8월재아원주원치료적38례위중、상부악성종류환자，수궤분위개복수술조、복강경수술조，매조19례。소유환자우술후12 h 급여동양장내영양병축량증가，공용6 d，전4 d 동시급여장외영양。관찰환자장공능회복시간、소화도증상，총단백（TP）、백단백（ALB）화전백단백（PA）수평이급각충상관병발증발생솔등。결과복강경수술조교개복수술조술후장공능회복시간현저제전（P ＜0.01），복강경수술조영양지지후백단백、전백단백현저고우개복수술조（균 P ＜0.01）。결론근치성전위절제술후환자접수조기장내영양지지，유리우영양상황회복，해영양도경안전、합리。인차，조기장내영양치료지지하복강경근치성전위절제술환자영양상황、장공능회복교개복수술우세명현。
Objective To evaluate the effect,safety and the resumption of gastrointestinal function of postoperative early enteral nutrition support after laparoscopic radical total gastrectomy and open surgery in patients with gastric cancer. Methods 38 cases with gastric cancer were randomly divided into two groups,19 cases treated by laparoscopic surgery were in laparoscopic group,and other 19 cases treated by open surgery were in open group. All cases were given enteral nutrition from the first postoperative day to the sixth day. The time of resumption of gastrointestinal function,gastrointestinal reaction,total protein(TP), albumin (ALB)and prealbumin (PA)were observed. Results The time of resumption of gastrointestinal function in laparoscopic group was significantly earlier than that in open group (P < 0.01). The albumin and prealbumin in laparoscopic group were significantly higherthan those in open group (all P < 0.01). Conclusions Early enteral nutrition is a safe and effective nutritional path way after radical total gastrectomy of gastric cancer. The resumption of gastrointestinal function in laparoscopic group is obviously better than that in open group.