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目的探讨肠内营养(EN)联合肠外营养(PN)对消化道肿瘤患者术后支持效果,并与全肠外营养(TPN)进行对比研究。方法选择消化道肿瘤手术病例230例,随机分为EN+PN组(119例)和PN组(111例)。EN+PN组在术中进行空肠穿刺留置营养管术。分别于手术前、术后1 d、术后10 d检测临床生化指标和T淋巴细胞亚群,并比较两组患者感染等并发症,平均肠功能恢复和住院时间。结果两组患者白蛋白(ALB)、总蛋白(TP)、CD3+和CD4+细胞在术后第1天有所下降,术后10 d明显升高,EN+PN组较PN组升高明显,具有显著性差异,且EN+PN组肠功能恢复及住院时间短,并发症发生率低。结论早期肠内营养联合肠外营养可改善消化道肿瘤患者术后营养和免疫状态,减少并发症,缩短住院时间,有利于术后恢复。空肠穿刺留置营养管术可作为消化道肿瘤开腹手术患者营养支持的首选方法。
Objective To investigate the effect of enteral nutrition (EN) and parenteral nutrition (PN) on the postoperative support of gastrointestinal cancer patients and to compare with total parenteral nutrition (TPN). Methods 230 cases of gastrointestinal cancer surgery were selected and randomly divided into EN + PN group (119 cases) and PN group (111 cases). EN + PN group in the operation of jejunum puncture nutrition management. Clinical biochemical indexes and T lymphocyte subsets were detected before operation, 1 d after operation and 10 d after operation. Complications such as infection and mean intestinal function recovery and hospital stay were compared between the two groups. Results The albumin (ALB), total protein (TP), CD3 + and CD4 + cells in both groups decreased on the first day after operation and were significantly increased on the 10th day after operation. The EN + PN group increased significantly compared with the PN group Significant difference, and EN + PN group intestinal function recovery and hospitalization time is short, the incidence of complications is low. Conclusion Early enteral nutrition combined with parenteral nutrition can improve postoperative nutrition and immune status of patients with gastrointestinal cancer, reduce complications, shorten the hospital stay, is conducive to postoperative recovery. Jejunal laparotomy nutrition tube surgery can be used as the preferred method of nutritional support for patients undergoing gastrointestinal tumor laparotomy.