Application Of Early Enteral Nutrition Through Jejunal Nutrition Tube In Recovery After Total Gastrectomy

Objective:To investigate the efficacy and safety of early enteral nutrition after total gastrectomy combined with preoperative hypoproteinemiaMethods:Retrospective analysis of patients who underwent total gastrectomy in our hospital from January 2010 to December 2018,49 patients were enrolled according to inclusion and exclusion criteria.According to the treatment,they were divided into jejunal nutrition group(23 cases)and jejunal nutrition tube group(26 cases),including early oral nutrition group(9 cases)and intravenous nutrition group(17 cases).The protein index,inflammatory stress index,postoperative complications,treatment compliance,hospital stay and short-term prognosis were compared between the three groups before and after the first 1-2,4-5 days.Then,the recovery of postoperative anastomotic leakage between the jejunal nutrition tube group and the unplaced jejunal nutrition tube group was comparedResults:White blood cells(WBC),c-reactive protein(CRP)procalcitonin(PCT),and neutrophil ratio in the first 1-2,4-5 sky enteral nutrition group,early oral nutrition group,and intravenous nutrition group There was no statistically significant difference in the results of N%)(P>0.05).The albumin and prealbumin between the jejunal nutrition group and the early oral nutrition group and the intravenous nutrition group were statistically different on the 4th to 5th day after surgery(P<0.05).The jejunal tube does not increase the tube-related complications.The incidence of complications among the three groups:the incidence of diarrhea is statistically significant(P<0.05);the incidence of gastric fistula,anastomotic leakage,intestinal obstruction,and pulmonary infection There was no significant difference between the groups(P>0.05).The recovery rate of patients with anastomotic leakage in the jejunal nutrition group was better than that of the patients without jejunal nutrition.The hospitalization time and hospitalization cost of patients with anastomotic leakage in the jejunal nutrition group were lower than those without the jejunal nutrition group.The ventilatory time and early oral nutrition group were shorter than the intravenous nutrition group,and the antibiotic use time was lower than that of the intravenous nutrition group(P<0.05),but the jejunal nutrition group There was no significant difference between the two groups(P>0.05).The compliance of the jejunal nutrition group was higher than that of the early oral nutrition group.Conclusion:1.For patients undergoing total gastrectomy with low protein before surgery,enteral nutrition of the jejunal nutrition tube can accelerate the recovery of postoperative nutritional status.2.jejunal nutrition tube for enteral nutrition can accelerate the recovery of patients with postoperative anastomotic leakage,shorten hospitalization time and costs.3.enteral nutrition through the jejunal nutrition tube is a safe and comfortable way of nutrition,can improve the compliance of patients with postoperative treatment.