The Effect Of Early Enteral Nutrition In Fast Track Surgery On Patients With Gastric Carcinoma After Radical Operation

Objective:This study aimed to analyze the effect of early enteral nutrition therapy to gastrointestinal function,nutritional status,immune function in gastrectomy postoperatively,and discuss the feasibility and safety of early enteral nutrition therapy on radical gastrectomy after operation in fast track surgery.Methods:The 56 cases of gastric cancer patients were randomly divided into enteral nutrition group and parenteral nutrition group,each group contained 28 cases.within 48 h,EN group started nasal drip intestinal enteral nutrition(TP-MCT)meanwhile PN group were treated with total parenteral nutrition and other conventional treatment,Two groups accepted nutritional support for 7 days.recording first anal exhaust and defecation postoperatively,weight measurements and review of blood lymphocyte count and albumin and prealbumin values before operation and after eight days,postoperative days in hospital and postoperative complications,mainly including anastomotic fistula or stump fistula,fat liquefaction,wound infection,lung infections,liver damage,stomach paralysis and so on,and two related indicators were compared.Result: Two groups of 56 patients complied well,and were cured accordi ng to the treatment plan without perioperative deaths.Postoperatively anal exhau st times of the EN group were 75.68±21.30 h,while the PN group were 101.46±21.30 h.The difference was statistically significant(P <0.05);Postoperative defecation times were 121.43±17.90 h and 132.14±22.33 h respectively,The d ifference was not statistically significant(P >0.05).Compared with postoperative weight(59.9±8.18)(kg)in EN group,the weight of postoperative patient body(54.4±8.68)(kg)reduced significantly in the EN group(P <0.05).The change of weight in the PN group was statistically significant(P < 0.05).Preopetative l ymphocyte count was equivalent to the difference which was not statistically si gnificant(P >0.05),Compared the EN group(1.56±0.30)(10~9/L)with the PN gr oup(1.11±0.24)(10~9/L).However,Lymphocyte count of the EN group(1.56±0.30) (10~9/L)was higher than the PN group(1.11±0.24)(10~9/L)after eight days.Albumin of the EN group(36.72±2.84)(g/L)was equivalent to that of PN group(35.45±2.36)(g/L).Prealbumin of the EN group(235.01±24.55)(mg/L)was signif icantly higher than the PN group(202.18±27.69)(mg/L),and the difference was statistically significant(P <0.05).Ig A、Ig G、Ig M at postoperative day 8 were(2.58±0.5)g/L、(13.00±1.41)g/L、(1.82±0.28)g/L in the EN group,(2.14±0.48)g/L、(10.57±2.21)g/L、(1.18±0.40)g/L in the PN group,with significant difference in both groups.Duration of postoperative stay were(11.6±1.40)d in the EN g roup,(13.0±1.72)d in the PN group,with significant difference in both groups(P<0.05).Incidence of complication in the EN group(2 cases)were no significant ly difference with that in the PN group(6 cases)(P >0.05).Conclusions: After radical gastrectomy to patients,early enteral nutrition therapy may improve the nutritional status,accelerate recovery of gastrointestinal function,enhance immune function and lower duration of postoperative stay.It should meet the opinion of fast track surgery.And it is regarded as a scientific and effective way of nutritional support.