Comparison Of The Effects Of Early Enteral Nutrition And Parenteral Nutrition On Patients With Advanced Gastric Carcinoma After Operation

Objective To evaluate the effects of early enteral nutrition (EEN) and parenteral nutrition (PN) on patients with advanced gastric carcinoma after operation.Methods Forty patients with advanced gastric carcinoma were randomly divided into EEN group (n=20) and PN group (n=20). Patients of EEN group received Intacted Protein Enteral Nutrition by nose- duodenum tube at 24th hour after operation, those of PN group received parenteral nutrition by subclavian vein, nutritional support were all maintained 7 days. Nutritional variables including total protein (TP), albumin (ALB), pre-albumin (PA); humoral immunity parameters including IgG, IgM and IgA; cell immunity parameters including CD3+, CD4+ and CD4+/CD8+ were measured on preoperative 1st day and postoperative 8th day by collecting early morning venous blood. Meanwhile, the clinical effects, the time of passage of gas by anus, incidence rate of adverse reaction,complication and nutrition-related costs were also observed.Results All patients in the course of the study with no serious complications or death. There was no significant difference between the two groups of all variables on preoperative 1st day. Compared with preoperative 1st day, the levels of CD4+ and CD4+/CD8+ in the EEN group on the postoperative 8th day were significantly higher (P<0.05), and the other parameters showed no significant difference. At the same time, on the postoperative 8th day, the recovery levels of IgA, CD4+ and CD4+/CD8+ in the EEN group were significantly higher than that in PN group (P<0.05). Mean while the recovery levels of PA, ALB and TP in the EN group were higher than that in PN group (P>0.05). Patients with adverse reactions in the EEN group were 5 cases and 4 cases in the PN group, the incidence rates were 25% and 20%;Patients with infectious complications in the EEN group were 1 cases and 4 cases in the PN group, the incidence rates were 5% and 20%. Compared with PN group, the time of passage of gas by anus and nutrition-related costs in the EN group was significantly decreased (P<0.05).Conclusions Compared with PN supplements, EEN supplements for advanced gastric cancer patients after operation have more obvious advantage: restoring gastrointestinal tract function earlier, efficiently ameliorating the nutrition state, restoring the immune function, decreasing the postoperative incidence of infectious complications and nutrition-related costs. Therefore, EEN is a safe, effective and economical method of nutritional supplements and it is a preferred method of nutritional support for patients with advanced gastric carcinoma after operation at prophase.