CAJ | 학술논문

目的：探索影响老年胃癌患者术后早期肠内营养(EEN)耐受性的因素，以及EEN联合肠外营养(PN)在老年胃癌患者中的应用前景。方法：选取笔者所在医院收治的82例老年胃癌患者，其均行手术，术后营养支持，按照随机、自愿原则将其分EEN+PN组、全胃肠外营养(TPN)组。检测两组患者胃肠道功能恢复、并发症发生率等相关指标。并对EEN的耐受性进行Logistic多因素回归分析。结果：EEN+PN组胃肠道功能恢复时间较TPN组短，差异有统计学意义(P<0.01)。两组均无死亡病例，并发症发生率两组比较差异无统计学意义(P>0.05)。EEN+PN组平均住院时间较TPN组短，差异有统计学意义(P<0.05)；术后第7天EEN+PN组检验学指标改善较TPN组明显，差异有统计学意义(P<0.05)。影响老年胃癌患者术后EEN耐受性的因素为：手术方式、营养液浓度及输注量。结论：胃空肠吻合术后患者对早期肠内营养易耐受，控制肠内营养液浓度、输注量，可更好地应用于老年胃癌患者的术后营养支持。肠内营养相比肠外营养更符合生理状态，在老年患者当中优势突出，表现为胃肠道功能恢复快、住院时间缩短、营养状况及免疫功能改善等，适合临床推广。
목적：탐색영향노년위암환자술후조기장내영양(EEN)내수성적인소，이급EEN연합장외영양(PN)재노년위암환자중적응용전경。방법：선취필자소재의원수치적82례노년위암환자，기균행수술，술후영양지지，안조수궤、자원원칙장기분EEN+PN조、전위장외영양(TPN)조。검측량조환자위장도공능회복、병발증발생솔등상관지표。병대EEN적내수성진행Logistic다인소회귀분석。결과：EEN+PN조위장도공능회복시간교TPN조단，차이유통계학의의(P<0.01)。량조균무사망병례，병발증발생솔량조비교차이무통계학의의(P>0.05)。EEN+PN조평균주원시간교TPN조단，차이유통계학의의(P<0.05)；술후제7천EEN+PN조검험학지표개선교TPN조명현，차이유통계학의의(P<0.05)。영향노년위암환자술후EEN내수성적인소위：수술방식、영양액농도급수주량。결론：위공장문합술후환자대조기장내영양역내수，공제장내영양액농도、수주량，가경호지응용우노년위암환자적술후영양지지。장내영양상비장외영양경부합생리상태，재노년환자당중우세돌출，표현위위장도공능회복쾌、주원시간축단、영양상황급면역공능개선등，괄합림상추엄。
Objective:To explore the effects in elderly patients with gastric cancer early postoperative enteral nutrition (EEN) tolerance factor,and EEN joint parenteral nutrition (PN) in elderly patients with gastric cancer application prospect.Method:Select the author’s hospital treated 82 cases of elderly patients with gastric cancer and its line of surgery,postoperative nutritional support,the points in accordance with the principle of random,voluntary EEN+PN group,total parenteral nutrition(TPN) group. Detection of two groups of patients with gastrointestinal function recovery,complications and related indicators. And tolerance of EEN Logistic multifactor regression analysis.Result:EEN+PN group of gastrointestinal function recovery time was shorter than the TPN group,the difference was statistically significant (P<0.01). In the two groups had no deaths and complications is similar between the two groups has no statistical significance (P>0.05). The average length of hospital stay in EEN+PN group was shorter compared with TPN group,the difference was statistically significant (P<0.05);after 7 days in EEN+PN group test indexes improve significantly in the TPN group,the difference was statistically significant (P<0.05). The factors influencing postoperative EEN tolerance in elderly patients with gastric cancer:surgery way,infusion of nutrient solution concentration and the amount.Conclusion:It is easy for patients with standing EEN after gastrojejunostomy. EEN could be well used in elderly patients if concentration and volume of the solution were appropriately controlled.Comparing with parenteral nutrition,enteral nutrition is more of in line with the physiological state. Early enteral nutrition support has more advantages in elderly patients,sachas quick recovery of gastrointestinal function,shrinking time during hospital,improving on nutritional and immunologic function etc.,so it is suitable for clinical promotion.