中文摘要：

目的探讨螺旋型鼻肠管在胃癌根治术加速康复中的临床价值。方法回顾性分析2012年6月至2014年6月上海交通大学医学院附属瑞金医院收治的74例胃癌患者行胃癌根治术的临床资料。因心理接受程度及经济水平差异，36例患者通过术中放置螺旋型鼻肠管行术后营养支持治疗，为鼻肠管组；15例患者通过术中空肠造瘘行术后营养支持治疗，为空肠造瘘组；23例患者因治疗时间较早，采用传统的术后营养支持治疗方式，术后行肠外营养支持治疗，为肠外营养组。术后定期检测和比较3组患者血清Alb、前白蛋白、淋巴细胞数、IgA、IgG、IgM，术后肛门排气时间，术后并发症发生情况（切口感染、腹腔感染、肠梗阻、消化道漏及切口延迟愈合）及术后住院时间。采用门诊和电话方式进行随访，随访时间截至2014年9月。正态分布的计量资料以x-±s表示，3组比较采用方差分析，两两比较采用LSD-t检验；计数资料比较采用，检验和Fisher确切概率法。结果3组患者均治愈出院，无围术期死亡患者；无腹腔感染、肠梗阻及切口延迟愈合等并发症发生。鼻肠管组患者术后第3天Alb、淋巴细胞数、IgA、IgG、IgM分别为（34±4）g／L、（0．9±0．3）×10^9／L、（1．9±0．8）g／L、（9．5±2．1）g／L、（1．00±0．29）g/L；空肠造瘘组患者分别为（34±4）g／L、（0．8±0．7）×10^9／L、（1．6±1．2）g／L、（8．2±1．4）g／L、（0．91±0．15）g／L；肠外营养组患者分别为（31±5）g／L、（0．9±0．3）×10^9／L、（1．7±1．0）g／L、（9．3±1．8）g／L、（0．97±0．33）g／L，3组比较，差异无统计学意义（F=2．168，1．745，2．115，2．189，2．124，P〉0．05）。鼻肠管组患者术后第7天Alb、淋巴细胞数、IgA、IgG、IgM分别为（36±5）g／L、（1．7±0．5）×10^9／L、（2．3±1．2）g/L、（10．5±1．9）g/L、（1?

英文摘要：

Objective To investigate the clinical value of helical nasointestinal tube placement in the enhanced recovery of patients with the radical gastrectomy for gastric cancer. Methods The clinical data of 74 patients who received radical gastrectomy at the Ruijin Hospital of Shanghai Jiaotong University from June 2012 to June 2014 were retrospectively analyzed. Thirty-six patients who received parenteral nutrition via helical nasointestinal tube were in the nasointestinal tube group, 15 patients who received nutritional support from the sinus tract after jejunostomy were in the jejunostomy group, 23 patients who received postoperative traditional parenteral nutrition duo to early treatment were in the parenteral nutrition group. The levels of albumin, prealbumin, number of lymph nodes, immunoglobin A （IgA）, immunoglobin G （IgG） and immunoglobin M （IgM） , the postoperative flatus time, incidence of postoperative complications （wound infection, peritoneal infection, intestinal obstruction, digestive tract leakage and delayed healing of incision） and duration of postoperative stay in the 3 groups were compared. Patients were followed up via out-patient examination and telephone interview till September 2014. The normal distribution measurement data were presented as x ± s. The comparison among groups and pairwise com- parison were evaluated with the analysis of variance and the LSD-t test. The count data were analyzed using the chi-square test or Fisher exact probability. Results All the patients in the 3 groups were cured and discharged without perioperative death. No peritoneal infection, intestinal obstruction or delayed healing of incision occurred. The levels of albumin, number of lymph nodes, IgA, IgG and IgM at postoperative day 3 were （34 ± 4 ） g/L, （0.9 ± 0.3 ） ×10^9/L, （ 1.9 ± 0.8） g/L, （9.5 ± 2.1） g/L, （ 1.00 ± 0.29） g/L in the nasointestinal tube group, （34±4）g/L,（0.8 ±0.7） ×10^9/L, （1.6 ± 1.2）g/L, （8.2 ± 1.4）g/L, （0.91±0.15） g/L in the jeju