| Objective:To study patients with gastric cancers on the safety of early oral feeding with enteral nutrition after the operation and the influences of clinical outcomes,nutritional status,immune functions and stress level.Methods :A total of 90 gastric cancer patients in our department from July 2015 to October 2016 were enrolled in the study.Finally the experimental group with 38 cases who was treated by receiving water and enteral nutrition early after the operation and control group with 42 cases who was under conventional perioperative treatment;We record postoperative fever time,time to flatus,hospital stay and medical cost to compared two groups of patients' recent clinical outcomes;Data were collected on Serum albumin,prealbumin,and retinol-binding protein on the preoperative,postoperative first,third and seventh day to compare nutritional status;Data were collected on CD4+T,CD4+T/CD8+T,Ig G,Ig M,Ig A on the preoperative,postoperative first,third and seventh day to compare immune functions;Data were collected on CRP,IL-6 and Tnf-? on the preoperative,postoperative first,third and seventh day to compare stress level;We record the completion rate of the early oral feeding with enteral nutrition in experimental group after their operations from the second day to sixth day.Results: Compared to control group,patients in experimental group had a shorter duration of postoperative fever[(74.63±7.56)h vs(80.33±8.57)h,P < 0.05],a shorter interval to flatus[(75.24±6.17)h vs(80.74±8.58)h,P<0.05],a shorter hospital stay[(8.24±2.46)d vs(9.5±1.66)d,P < 0.05]and medical cost[(58.18±5)thousand yuan vs(63.04±4.36)thousand yuan,P < 0.05]which significantly decreased.There was no significant difference in complication morbidity between the two groups.[13.2%(5/38)vs16.7%(7/42),P > 0.05];There was no significant difference between the experimental group and control group's serum albumin on the preoperative,first and third postoperative day(P > 0.05).Serum albumin of patients in the experimental group were higher than that of the control group on the seventh postoperative day(P < 0.05).There was no significant difference between the experimental group and control group's prealbumin and retinolbinding protein on the preoperative and first postoperative day(P > 0.05).Prealbumin and retinol-binding protein of patients in the experimental group were higher than that of the control group on the third and seventh postoperative day(P < 0.05);There was no significant difference between the experimental group and control group's CD4+T on the preoperative,first and third postoperative day(P > 0.05).CD4+T of patients in the experimental group were higher than that of the control group on the seventh postoperative day(P < 0.05).There was no significant difference between the experimental group and control group's CD4+/CD8+ on the preoperative and first postoperative day(P > 0.05).CD4+/CD8+ of patients in the experimental group were higher than that of the control group on the third and seventh postoperative day(P < 0.05);There was no significant difference between the experimental group and control group's Ig G,Ig M,Ig A on the preoperative and first postoperative day(P > 0.05).Ig G,Ig M,Ig A were higher than that of control group on the third and seventh postoperative day(P < 0.05);There are no difference between the experimental group and control group's CRP,IL-6 and Tnf-? on the preoperative and first postoperative day(P > 0.05).CRP,IL-6 and Tnf-? of patients in the experimental group were lower than that of the control group on the third and seventh postoperative day(P < 0.05).The completion rate of early oral feeding with enteral nutrition in experimental group was gradually increasing between the second day and the sixth postoperative day.Conclusion:Early oral enteral feeding after gastric cancer surgery can improve patient's nutritional status,immune function,reduce the stress respond related to surgery and accelerate rehabilitation. |
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