早期经口进食在远端胃癌根治术后的应用

【】　目的　探讨远端胃癌根治术后早期经口进食的可行性、安全性及术后早期康复情况。　方法　将2009年5月-2011年1月收治的62例远端胃癌根治术患者随机分为早期经口进食（earlyoralfeeding，EOF，30例）组及传统进食（traditionalfeeding，TF，32例）组。比较两种营养支持方法对患者术后并发症、胃肠功能恢复及血清蛋白的影响。　结果　EOF组术后早期经口进食耐受率达90%（27/30），两组术后并发症发生率相比差异无统计学意义（χ2=0.046，P=0.830）。EOF组术后首次肛门排气及排便时间均早于TF组（P=0.000）。术后8d时EOF组血清前清蛋白和转铁蛋白明显高于TF组（P=0.028，0.013）。　结论　远端胃癌根治术后早期经口进食是安全、可行的，能促进患者的早期恢复。【Abstract】　Objective　Todiscussthefeasibilityandsafetyofearlyoralfeedingaftercurativesurgeryfordistantgastriccancer,andinvestigatewhetherithasaneffectonearlyrecoveryofthedisease.　Methods　FromMay2009toJanuary2011,62distalgastriccancerpatientswithopenradicalresectionweredividedintotheearlyoralfeedinggroup(EOFgroup,n=30)andtraditionalfeedinggroup(TFgroup,n=32)randomly.Wecomparedthecomplicationrate,gastrointestinalfunctionrecovery,serumproteinchangebeforeandafteroperationbetweenthetwogroups.　Results　Earlyoralfeedingcanbetoleratedbyasmuchas90%(27/30)ofthepatientsinEOFgroup.Therewasnosignificantdifferenceinthepostoperativecomplicationratebetweenthetwogroups(χ2=0.046,P=0.830).TheEOFgrouphadafasteronsetofflatusanddefecationthantheTFgroup(P=0.000).Theserumpre-albuminandtransferrinweresignificantlyhigherintheEOFgroupthanthoseintheTFgroup8daysafteroperation(P=0.028,0.013).　Conclusion　Earlyoralfeedingaftercurativesurgeryfordistalgastriccancerissafeandfeasible,andcanpromoteearlyrehabilitationofthepatients.