Total Parenteral Joint Enteral And Parenteral Nutrition On Radical Operation For Carcinoma Of Stomach Effect A Radical Cure Early Postoperative Nutrition Curative Effect Analysis

Purpose: As a commom digestive tract tumor,gastric cancer tends to attack the elderly population,especially the group over 45 years old.Oeing to the difficulties in early screening and diagnosis,most suffers have been in the advanced phase when they go see doctors.At present,surgical therapy is the main therapeutic measures for gastric cancer suffer in the advanced phase.Due to the surgical trauma,postoperative stress and the pains caused by tumor,the nutrition status of the suffers is under great influence.Therefore,the nutrition support after operative plays an important role in improving the suffers?nutrition status,lower the risk of malnutrition,and accelerate the progress of postoperative recovery.Enteral nutrition and parenteral nutrition are the common ways to conduct nutrition support for now,however,it emphasize on different aspects.The research aims at analyzing and getting to know the early stage clinical effect on gastric cancer sufferer in advanced phase when taking TPN and EPN as nutrition support,s treatment.Research meathods: 1.Object of study October 2014 to October 2015,our department performed distal gastrectomy for 40 gastric cancer suffering at advanced phase.And divided into TPN and EPN both 20 cases randomly.2.obvervational indexAnalyses and comparison the nutritive index of two groups undergoing different nutritive treatment includes: PA,RBP,TRF,TSF and AMC,the recovery time of gastroenteric function after operation,the length of stay,AST,ALT and incidence rate of complication.3.Research procedures Screened 40 gastric cancer suffering at advanced phase and divided into TPN and EPN both 20 cases randomly.TPN group,patients were given Cavan 1440 ml and medium / long chain fat emulsion injection 500 ml,5% dextrose injection 1000 ml and vitamins and trace elements by peripheral intravenous dripping at the beginning of the first day after surgery until the eighth day;EPN group,patients were given the Cavan 1440 ml and medium / long chain fat emulsion injection 500 ml,5% dextrose injection 1000 ml vitamins and trace elements by peripheral intravenous dripping at the first day and the next day.On the third day,they were given Calvin 1440 ml and medium / long chain fat emulsion injection 500 ml by peripheral intravenous dripping and fed enteral nutrition infusion fluid 500 ml by nasogastric tube.The forth day,Cavan 1440 ml and medium / long chain fat emulsion injection 250 ml and enteral nutrition infusion 1000 ml were given.On the fifth day,Calvin and medium / long chain fat emulsion injection were disabled and continue to give enteral nutrition infusion 1500 ml by nasogastric tube.All the suffers nutrition index include PA,RBP,TRF,ALT,AST were detected by nenous blood in preoperative,the third day and the eight day of postoperative.Measured TRF and AMC,observed and record the recovery time of gastroenteric function after operation,the length of stay,and incidence rate of complication.4.Statistical analysis: The results using SPSS22.0 statistical software for statistical analysis between the two groups using independent sample t-test was used tocompare different times within the group paired t test,measurement data as mean ± standard deviation(X ± s)represent count data using chi-square test,P <0.05 for the difference was significant,statistically significant.Result:It included trials in two groups of patients during hospitalization no serious complications or death.1?In TPN group and EPN group,the RBP,TSF,PA index of gastric cancer patients showed no difference(P> 0.05)before the surgery.Three days after the operation,the two groups' RBP,TSF,PA index were significantly decreased than that in pre-operation,the difference was statistically significant(P <0.05).On the third postoperative day,TPN group and EPN group had no significant difference between the two groups(P> 0.05);2?In TPN group and EPN group,patients accepted different nutritional support treatment.On the eighth postoperative day,RBP,TSF,PA were better than that of the third postoperative day.It indicated that nutritional support treatment was effective.And EPN group's RBP,TSF,PA index growth above TPN group's was statistically significant(P <0.05);3?TPN group,EPN group patients,AMC and TSF in the third postoperative day were significantly decreased than that in pre-operation(P <0.05).In TPN group,AMC in the eighth postoperative day were significantly increased than that in the third postoperative day,P value of 0.001,with a clear differences;In EPN group,TSF in the eighth postoperative day had no significant change compared with that in the third postoperative day,P value of 0.104,with no significant difference;On the eighth postoperative day,AMC and TSF of EPN group compared with TPN group increased not significantly(P> 0.05).4.The hospitalization time and postoperative ventilation time in EPN group were significantly shorter than those in TPN group,the difference was statistically significant(P <0.05).5.In TPN group and EPN group,the ALT and AST of patients had no significant difference between preoperative and postoperative.And that in the eighth postoperative day had no significant change compared with that in the third postoperative day(P> 0.05).Different therapeutic approaches for patients with nutritional support no significant difference in liver function.Conclusion: After the radical gastrectomy,enteral nutrition combined with parenteral nutrition can more effectively improve the patient's nutritional status than total parenteral nutrition.And it can also shorten the recovery time of gastrointestinal tract,shorten the hospitalization time,promote the speed of recovery of the patient.