Objective: To assess the effects of different nutritional support methods on postoperative recovery in patients with gastric cancer. Methods: 98 patients who received radical gastrectomy were divided into three groups: parenteral nutrition group (PN group) (n=36), early enteral nutrition group (EEN group) (n=33) and early oral feeding group (EON group) (n=29). Tolerance of enteral nutrition, postoperative recovery and economic indicators were compared. Results: The number of laparoscopic-assisted surgeries was 18, 17 and 25 in PN group, EEN group and EON group, respectively. There was no significant difference in sex, age and body mass index(BMI) among the three groups. Gastrointestinal function recovered slowly in 3 cases, including 2 cases in EEN group and 1 case in EON group. 1 case in EON group had abdominal hemorrhage. Median postoperative hospital stay in PN, EEN and EON group was 11.0, 11.0 and 8.0 days respectively, and significant reduction can be found in EON group(P<0.001). The complication rates were 30.5% (11 cases), 12.1% (4 cases), and 13.8% (4 cases), respectively, with no statistically significant difference(P=0.102). The median nutritional support costs for PN group, EEN group, and EON group were 4 543.3, 974.2, and 265.0 yuan, respectively. The median albumin consumption was 90.0, 40.0, and 0 g, respectively. The EON groups were significantly lower (P<0.001). The results of the laparoscopic assisted subgroup and the ones of whole group were consistent. Conclusion: Compared with parenteral nutrition and early enteral nutrition, early oral feeding can reduce the amount of albumin consumption, decrease the cost of nutrition support and shorten the average hospital stay after surgey without increasing the incidence of complications.
目的： 评估不同营养支持方式对胃癌患者术后恢复的影响。 方法： 选取行胃癌根治术治疗胃癌患者98例，按照术后营养支持方式分为肠外营养组(36例)、早期肠内营养组(33例)和早期经口进食组(29例)，比较3组患者的肠内营养耐受情况、术后恢复情况及卫生经济学指标。 结果： 肠外营养组、早期肠内营养组和早期经口进食组采用腹腔镜辅助手术的患者分别有18、17和25例。3组患者性别、年龄和体质指数差异均无统计学意义(均P>0.05)。早期肠内营养组2例患者胃肠道功能恢复缓慢；早期经口进食组1例患者胃肠道功能恢复缓慢，1例患者腹腔出血。肠外营养组、早期肠内营养组和早期经口进食组患者的中位术后住院天数分别为11.0、11.0和8.0 d，早期经口进食组患者术后住院天数明显减少(P<0.001)；并发症发生率分别为30.5%(11例)、12.1%(4例)和13.8%(4例)，差异无统计学意义(P＝0.102)。肠外营养组、早期肠内营养组和早期经口进食组的中位营养支持费用分别为4 543.3、974.2和265.0元，中位白蛋白使用量分别为90.0、40.0和0 g,早期经口进食组均明显降低(P<0.001)。对腹腔镜辅助亚组相关指标的分析结果与全组患者的分析结果一致。 结论： 与肠外营养和早期肠内营养相比，胃癌患者术后早期经口进食能减少白蛋白使用量，降低营养支持费用，减少术后住院天数，同时不增加术后并发症的发生率。.
Keywords: Complications; Nutritional support; Postoperative hospital stay; Radical gastrectomy; Stomach neoplasms.