早期肠内营养对胃癌患者根治性切除术后近期临床结局的影响

Effect of Early Enteral Nutrition on Short-Term Clinical Outcomes of Patients with Gastric Cancer after Radical Resection

摘要: 目的：观察早期肠内营养制剂在胃癌患者术后恢复过程中的作用。方法：2019年9月至2020年6月，于青岛大学附属医院胃肠外科纳入患者80名，按照1:1的比例随机分为试验组和对照组。试验组患者术后早期使用肠内营养制剂，对照组使用肠外营养支持。主要观察指标为首次排气(h)、排便时间(h)，次要观察指标为术后胃肠不良反应(恶心、呕吐、腹胀、腹泻)发生率，切口感染率，Clavien-Dindo分级以及术后住院天数(d)。收集术后第1、3、7天血液分析血清白蛋白浓度。结果：与对照组相比，试验组术后首次排气、排便时间更快(P < 0.05)，腹胀发生率高于对照组，但无统计学差异(P > 0.05)。且试验组患者术后第3、7天白蛋白浓度高于对照组(P < 0.05)。结论：术后早期肠内营养能够促进胃癌患者术后恢复，改善近期临床结局，可以安全且有效地应用于胃癌患者术后早期恢复过程中。

Abstract: Objectives: To evaluate the effects of early enteral nutrition on improving short-term clinical outcomes on patients with gastric cancer who underwent radical gastrectomy. Methods: From September 1, 2019 to June 1, 2020, a total of 80 patients with gastric cancer were enrolled in the Department of Gastrointestinal Surgery of the Affiliated Hospital of Qingdao University. Patients were randomly assigned into Experimental Group (EG) and Control Group (CG) at a 1:1 ratio. Patients in EG received early enteral nutrition after radical resection, and patients in CG received routine care. The primary outcomes were the time of first postoperative flatus (h) and defecation (h), incidence of postoperative nausea, vomiting, distention, diarrhea, incidence of incision infection, Clavien-Dindo grade and length of postoperative stay. We collected the blood on postoperative day POD 1, POD 3 and POD 7 to analyze the concentration of albumin. Results: Overall, 80 patients were enrolled in the analysis. As shown are the results, the time of first postoperative flatus in EG was significantly shorter than CG (P < 0.05). The incidence of distension was higher in EG but no significant difference was found (P > 0.05). Furthermore, we found that the concentration of albumin on POD 3, POD 7 was higher in EG (P < 0.05). Conclusions: Early postoperative enteral nutrition can promote the postoperative recovery and improve the short-term clinical outcomes of patients with gastric cancer. It can be safely and effectively applied in the early rehabilitation process of gastric cancer patients.