Comparison on the influences of early parenteral nutrition and enteral nutrition on the nutrition, immune, and liver function state of patients with total gastrectomy

Abstract

Objective To compare the influence of early parenteral nutrition and enteral nutrition on the nutrition,immune,and liver function state of patients with total gastrectomy.Methods A total of 90patients with total gastrectomy in our hospital from July 2010 to October 2012 were selected as research objects,and were randomly divided into group A (early parenteral nutrition group,n =45)and group B(early enteral nutrition group,n =45).The nutrition state indexes,immune state indexes,and liver function indexes of two groups before the intervention and at 3th and 10th day after the intervention were compared.Results The nutrition state indexes[3rd d:TP (68.35 ±3.02)g/L,A (38.94 ±4.69)g/L,PAB (273.54 ±29.68) mg/L,TRF (2.14 ±0.29) g/L,Hb (129.84 ±7.92) g/L;10th d:TP (72.59 ± 3.52)g/L,A (42.31 ±5.49)g/L,PAB (305.57 ±30.95)mg/L,TRF (2.78 ±0.31)g/L,Hb (135.87 ±8.95) g/L],immune state indexes [3rd d:IgA (0.94 ± 0.10) g/L,IgG (9.24 ± 0.63) g/L,IgM (1.51 ±0.14) g/L,RBC-C3bR (10.54 ± 0.52) ％,RBC-ICR (12.21 ± 1.41) ％ ; 10th d:IgA (1.23 ± 0.15) g/L,IgG (10.98 ±0.72)g/L,IgM (1.71 ±0.18) g/L,RBC-C3bR (13.74 ±0.69)％,RBC-ICR (9.27 ±1.05)％],and liver function indexes[3rd d:ALT (32.59 ±3.56)U/L,AST (33.95 ±4.03) U/L,TBIL(12.07± 1.38)μmol/L,GGT (24.03 ±2.59) U/L;10th d:ALT (22.93 ±3.18) U/L,AST (24.84 ±3.29) U/L,TBIL (10.50 ± 0.96) μmol/L,GGT (20.70 ± 2.49) U/L] in group B at 3rd and 10th day after the interventiont were all better than those in group A [3rd d:TP (64.59 ± 2.83)g/L,A (35.53 ±4.37)g/L,PAB (224.96 ±25.50)mg/L,TRF(1.63 ±0.20)g/L,Hb (121.03 ±7.18)g/L,IgA (0.68±0.07)g/L,IgG (7.32 ±0.51)g/L,IgM (1.12 ±0.10)g/L,RBC-C3bR (8.13 ±0.40)％,RBC-ICR (14.59 ±1.54)％,ALT (40.26 ±4.13)U/L,AST (40.95 ±4.26)U/L,TBIL (16.37 ± 1.75)μmol/L,GGT (31.45 ±2.97) U/L;10th d:TP (66.96 ±2.97) g/L,A (36.01 ±4.43) g/L,PAB (241.35 ±26.63) mg/L,TRF (1.86 ± 0.24) g/L,Hb (127.69 ± 7.73) g/L,IgA (0.81 ± 0.08) g/L,IgG (8.54 ±0.55) g/L,IgM (1.28 ± 0.12) g/L,RBC-C3bR (8.52 ± 0.46) ％,RBC-ICR (13.07 ± 1.46) ％,ALT(31.52 ± 3.84) U/L,AST (33.54 ± 3.90) U/L,TBIL (13.21 ± 1.41) μmol/L,GGT (25.39 ± 2.65) U/L],and these indexes in group B at 10th day after the intervention were all significantly better than those at 3rd day after the intervention (all P ＜ 0.05).Conclusions The early enteral nutrition palys an active role in improving the nutrition,immune,and liver function state of patients with total gastrectomy,and it provides the necessary premise for the postoperative rehabilitation of patients. Key words: Enteral nutrition; Parenteral nutrition; Gastrectomy; Nutritional status; Immunity