目的 研究胃底贲门癌术后早期应用自制营养液的可行性、安全性和应用价值.方法 将145例胃底贲门癌患者随机分为肠内组73例和肠外组72例,肠内组术后第1天起从肠内营养管输入自制营养液加少量肠内营养混悬液(能全力)6~8d,肠外组术后第1天起经静脉输入肠外营养6~8 d.比较两组患者术后住院天数、住院费用、并发症及术后恢复情况等指标.结果 肠内组术后9d血浆白蛋白[(43.4±4.4)g/L]比肠外组[(35.0±3.7)g/L]明显升高(P<0.01),肠内组肛门排气、排便时间[(49.0±22.5)h、(74.4±7.3)h]均比肠外组[(70.1±20.1)h、(96.6±12.7)h]早(P<0.01),平均住院费用/药费肠内组与肠外组分别为(9433.1±1024.6)/(3271.8±420.9)元、(12953.4±2919.7)/(4832.9±872.6)元(P<0.01);肠内组并发症总发生率比肠外组减少(P<0.01).结论 胃底贲门癌术后早期应用肠内自制营养液安全可行,符合生理要求,能促进肠功能恢复,快速改善患者术后营养状况.
Objective To investigate the efficiency, safety and application value of early utilization of nutrient of home-made formula in post-operation of gastric fundic cardia cancer patients. Methods One hundred and forty-five cases of gastric fundic cardia cancer patients were randomly divided into two groups,early enteral-intestinal nutrient formula of home-made (enteral-intestinal group,73 cases) and intra-venous nutrition (intra-venous group,72 cases). Patients in enteral-intestinal group were given home-mada nutrition-liquid plus nutrison fibre for 6-8 days from the first post-operation day, intravenous group were given venousnutrition injection for 6-8 days from the first post-operation day. The average residential day, spends,complications and recovery situation were recorded and compared between the two groups. Results The average residential day in enteral-intestinal group was less than that in intra-venous group, average spends /drugs cost were (9433.1±1024.6)/(3271.8±420.9) yuan vs (12 953.4±2919.7 )/(4832.9±872.6) yuan respectively (P < 0.01 ),the complication in enteml-intestinal group was less than that in intra-venous group (P < 0.01 ). Time of revive testinal function in enteral-intestinal group was earlier than that in intra-venous group,ALB in enteral-intestinal group was higher than that in intra-venous group (P < 0.01 ). Conclusion Early enteral-intestinal nutrient utilization of home-made formula in post-operation of gastric fundic cardia cancer patients is safe and applicable, it can improve patients' post-operation nutrition situation and intestinal function.