Objective: To assess the difference between early enteral nutrition (EEN group) and total parenteral nutrition (TPN group) after total gastrectomy for gastric cancer.
Method: The nutrition index, liver function, patient generated subjective global assessment (PG-SGA) score, the post-operation complications, the hospital stay and hospitalization expense of the postoperative patient after total gastrectomy, admitted to our Department of Surgery from May 2011 to May 2013 were analyzed retrospectively.
Results: A total of 72 patients including 37 cases in the EEN group and 35 cases in the TPN group were recruited. Hypoalbuminemia gradually improved in the EEN group about 3-5 days, but it did not increase until average 21 days in the TPN group. The body weight decreased in the EEN group during the first 2 weeks and recovered gradually in 21 days; body weight in the TPN group was significantly lower than the EEN group at 21 days (p<0.05). There were significant differences in both the groups (p<0.05) in nutrition indicators. The incidence of complications in the EEN group and TPN group were 8.1% and 25.7% respectively, with no significant differences (p>0.05). The days of hospital stays in the EEN and in the TPN group were up to 12.2 ± 2.5 d vs 14.9 ± 2.9 d (p<0.05) and the hospitalization expenses were 36472 ± 4833 CNY vs 40140 ± 3927 CNY (p<0.05), respectively.
Conclusion: Compared with TPN, EEN was safe and well tolerated and can shorten the hospital stay as well as reduce costs incurred with total gastrectomy for gastric cancer.
目的：评价胃癌患者全胃切除术后，早期肠内营养（EEN）与全肠外营养 （TPN）的差异。方法：收集2011 年5 月至2013 年5 月我科收治的胃癌全胃 切除患者，术后随机选择EEN 或TPN，对EEN 组和TPN 组患者术前及术后 的营养指标、肝功能、癌症患者营养评估标准（PG-SGA）、术后并发症、住 院时间以及住院费用进行对照研究。结果：符合入选标准的胃癌全胃切除患 者共72 例，其中EEN 组37 例，TPN 组35 例。EEN 组在术后3～5 天低白蛋 白血症逐渐改善，而TPN 组术后21 天才逐渐恢复。EEN 组术后14 天体重较 术前减轻，术后21 天逐渐恢复，而TPN 组在术后21 天内体重无明显恢复 （p<0.05）。两组营养指标有明显统计学差异（p<0.05）。ENN 组和TPN 组 并发症发生率分别为8.1%和25.7%，两组间无明显统计学差异（p>0.05）。 ENN 组住院时间为12.2±2.5 天，TPN 组为14.9±2.9 天（p<0.05），ENN 组和 TPN 组住院费用分别为36472±4833 元人民币和40140±3927 元人民币 （p<0.05）。结论：与TPN 相比，胃癌全胃切除术后选择EEN 安全、患者耐 受性好，并且可以缩短住院时间，减少住院总费用。