胃癌病人术后早期肠内营养不耐受的风险因素及对预后影响

发布时间：2018-01-19 10:47

本文关键词： 胃癌早期肠内营养肠内营养耐受风险因素　出处：《肠外与肠内营养》2017年03期 　论文类型：期刊论文

【摘要】：目的:研究胃癌病人术后早期肠内营养(EEN)不耐受的风险因素及其对预后的影响。方法:选取行胃癌根治术,且术后行EEN的75例胃癌病人的病历资料,根据术后EEN实施后病人是否出现恶心、呕吐、腹痛、腹胀和腹泻的症状,将病人分为EEN耐受组和不耐受组。结果:51例(68%)胃癌病人在术后实施EEN过程中出现了EN不耐受的症状,24例(32%)早期实施EN后耐受良好。不耐受组病人的手术类型、术后第1天下床活动时间、开始EN的时间和使用营养泵与耐受组之间存在明显差异。经多元回归分析发现,病人术后第1天下床活动时间4 h和使用EN泵是术后EEN耐受的有利因素(P0.05)。EEN不耐受组病人术后排气、排便时间和住院时间均明显长于耐受组。结论:胃癌病人术后下床活动时间不足及未使用EN泵进行匀速输注是EEN出现不耐受的风险因素,可延缓病人术后康复。
[Abstract]:Objective: to study the risk factors of early enteral nutrition intolerance and its influence on prognosis in patients with gastric cancer. Methods: radical gastrectomy was performed in patients with gastric cancer. According to the medical records of 75 patients with gastric cancer who underwent EEN after operation, whether the patients developed nausea, vomiting, abdominal pain, abdominal distension and diarrhea after EEN. The patients were divided into EEN tolerance group and intolerance group. Results 51 patients with gastric cancer developed en intolerance during EEN. The operation type of the patients in the group of intolerance and the time of getting out of bed on the first day after operation were good. There were significant differences between the time of starting en and the use of nutrition pump and tolerance group, which were found by multiple regression analysis. The time of getting out of bed for 4 hours on the first day after operation and the use of en pump were the favorable factors of postoperative EEN tolerance. The defecation time and hospitalization time were significantly longer than those in the tolerance group. Conclusion: insufficient time to get out of bed and no uniform infusion of en pump are the risk factors of EEN intolerance in patients with gastric cancer. It can delay the patient's recovery after operation.
【作者单位】：黄山市首康医院普通外科;南京军区南京总医院普通外科;
【分类号】：R459.3;R735.2
【正文快照】： 胃癌是临床上常见的消化系统恶性肿瘤,发生率呈上升趋势[1]。胃癌发病隐匿,早期胃癌多无症状或仅有轻微症状,因而中晚期病人较为多见。目前,胃癌根治术是胃癌病人的主要治疗手段[2]。胃癌病人本身在术前多伴有不同程度的营养不良,加之手术创伤、消化道生理结构改变等则可能进

【参考文献】