Early enteral nutrition on the nursing of elderly patient with gastric cancer after total gastrectomy

Abstract

Objective To discuss the clinical effects of early enteral nutrition on elderly patient with gastric cancer after total gastrectomy. Methods A total of 138 elderly patients with gastric cancer after total gastrectomy in Renji Hospital Shanghai Jiaotong University School of Medicine from September 2014 to September 2016 were selected using purposive sampling. They were divided into the observation (n=73) and control (n=65) groups using random number table. Patients in the control group were given parenteral nutritional support. The energy was 125 KJ/ (kg.d) ; nitrogen content was 0.15 g/ (kg.d) ; total fluid amount was 50 ml/ (kg.d) . They were prepared to bags of 3 L and given by intravenous dripping through internal jugular vein. After the anal exhaust and removing gastric tube, patients were routinely given from water to clear fluid diet, fluid diet, semi-fluid diet until normal diet. Patients in the observation group received indwelling three-lumen gastrojejunal tube. At 12 h after the operation, heating 100 ml 5% glucose were given through three-lumen gastrojejunal tube. At 24 h after the operation, Ruidai (enteral nutritional suspension-TPF) were given at the total 500 ml and increased by 500 ml/d until 1 500 ml at 4 d after the operation. The drop speed increased from 20 ml/h to 100 ml/h. The incidence of postoperative complications, the anal exhaust time, the leaving bed time, hospital days and nutritive indexes were compared between the two groups. Results The hospital days, anal exhaust time and the leaving bed time in the observation group were (12.9±5.9) d, (70.3±16.7) h and (15.24±13.28) h, which were significantly lower than those in the control group [ (18.6±6.9) d, (97.5±22.3) h and (29.95±15.23) h] (P<0.05) . There was 1 case of diarrhea in the observation group, while 2 cases of anastomotic leakage, 2 case of infection, 1 case of obstruction and 2 cases of diarrhea were observed in the control group. The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P<0.05) . The nutritive indexes at 7 d and 14 d after the operation in the observation group were statistically significantly better than those in the control group (P<0.05) . Conclusions Early enteral nutrition on elderly patient with gastric cancer after total gastrectomy can reduce the incidence of postoperative complications, improve the postoperative nutrition status, shorten the time of anal exhaust and leaving bed, and reduce the hospital days. Key words: Aged; Gastric neoplasms; Total gastrectomy; Early enteral nutrition