背景:ERAS（加速康復(fù)）是促進(jìn)患者早期恢復(fù)的一種多模式方法,通過對(duì)ERAS與常規(guī)方法的比較研究,認(rèn)為ERAS優(yōu)于常規(guī)方法,因此,ERAS方案被廣泛推薦。盡管ERAS被廣泛接受,但是其中的一些原則依然很難遵守。然而,研究表明,營(yíng)養(yǎng)和早期經(jīng)口飲食等具體途徑具有挑戰(zhàn)性,值得注意的是,有研究表明,營(yíng)養(yǎng)不良與手術(shù)壓力增加兩者之間有聯(lián)系。此外,胃切除術(shù)后營(yíng)養(yǎng)不良的患者往往會(huì)導(dǎo)致術(shù)后并發(fā)癥,這是由于先天免疫減弱、炎癥反應(yīng)、術(shù)后腸梗阻持續(xù)時(shí)間較長(zhǎng)所致,腸道通透性、虛弱、血糖水平不穩(wěn)定和更多的營(yíng)養(yǎng)并發(fā)癥導(dǎo)致術(shù)后預(yù)后不良�；颊咴谛g(shù)后1-3天經(jīng)口給予流質(zhì)飲食。這可能不能夠提供足夠的營(yíng)養(yǎng)來促進(jìn)機(jī)體免疫系統(tǒng),同時(shí)也不能為胃癌患者提供足夠的能量,以實(shí)現(xiàn)加速康復(fù)的目標(biāo)。值得注意的是,由于ERAS指南建議取消EN（腸內(nèi)營(yíng)養(yǎng)）進(jìn)食,因此尚無關(guān)于通過腸內(nèi)營(yíng)養(yǎng)治療胃癌的ERAS患者的數(shù)據(jù)。目的:當(dāng)前的研究旨在分析來自幾項(xiàng)觀察性隊(duì)列研究的可用證據(jù),然后進(jìn)行一項(xiàng)回顧性研究,以對(duì)飼管的重要性及其在ERAS指導(dǎo)下的益處進(jìn)行回顧性研究。方法:所有分析均由Review Manager（Rev-Man）5.3、（SPSS）22版或（S... 

【文章來源】：江蘇大學(xué)江蘇省

【文章頁(yè)數(shù)】：80 頁(yè)

【學(xué)位級(jí)別】：碩士

【文章目錄】：
ABSTRACT
摘要
CHAPTER1:INTRODUCTION
    1.1 CURRENT AND FUTURE IMPLEMENTATION OF ERAS PATHWAYS
    1.2 PRE-OPERATIVE PERIOD
        1.2.1 Information
        1.2.2 Optimization
        1.2.3 Physiotherapy
        1.2.4 Nutrition support
        1.2.5 Mechanical bowel preparation
        1.2.6 Fasting
        1.2.7 Opioid sparing
    1.3 OPERATIVE PERIOD
        1.3.1 Prophylactics
        1.3.2 Anaesthesia
        1.3.3 Surgical stress
        1.3.4 Fluid therapy
        1.3.5 Prophylactic feeding tubes
    1.4 POSTOPERATIVE PERIOD
        1.4.1 PONV
        1.4.2 Early oral feeding
        1.4.3 Balanced analgesia
        1.4.4 Early mobilization
    1.5 FEASIBILITY AND BENEFITS OF ERAS PATHWAYS
    1.6 CHALLENGES ARGUMENTS AND IMPROVEMENTS
    1.7 FUTURE DIRECTIONS
    1.8 SUMMARY
CHAPTER2:SHORT-TERM EVALUATION OF IMMUNE LEVELS AND NUTRITIONAL VALUES OF EN VERSUS PN IN GASTRIC CANCER:A SYSTEMATIC REVIEW AND A META-ANALYSIS
    2.1 BACKGROUND
    2.2 METHODS
        2.2.1 Retrieval strategy
        2.2.2 Inclusion and exclusion criteria
    2.3 STATISTICAL ANALYSIS
    2.4 RESULTS
        2.4.1 General characteristics
        2.4.2 Analysis of immune indicators
        2.4.3 Analysis of Nutrition indices
        2.4.4 Analysis of postoperative clinical outcomes
    2.5 ASSESSMENT OF PUBLICATION BIAS
    2.6 DISCUSSION
    2.7 CONCLUSIONS
    2.8 FUTURE DIRECTIONS
CHAPTER3:RETROSPECTIVE STUDY ON CLINICAL OUTCOMES OF GASTRIC CANCER PATIENTS UNDER MODIFIED NUTRITION IN ERAS
    3.1 BACKGROUND
    3.2 MATERIALS,METHODS AND ANALYSIS
        3.2.1 Enteral nutrition suspension and tube
        3.2.2 Inclusion and exclusion criteria
        3.2.3 Statistical analysis
    3.3 RESULTS
        3.3.1 Clinical indices
    3.4 DISCUSSION
CHAPTER4:GENERAL CONCLUSION AND RECOMMENDATIONS
    4.1 GENERAL CONCLUSION
    4.2 RECOMMENDATIONS
REFERENCES
LIST OF ABBREVIATIONS
LISTS OF PUBLICATIONS
ACKNOWLEDGEMENT
Study limitations
Ethics


【參考文獻(xiàn)】：
期刊論文
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[2]Enhanced recovery program is safe and improves postoperative insulin resistance in gastrectomy[J]. Nobuaki Fujikuni,Kazuaki Tanabe,Noriaki Tokumoto,Takahisa Suzuki,Minoru Hattori,Toshihiro Misumi,Hideki Ohdan.  World Journal of Gastrointestinal Surgery. 2016(05)
[3]早期腸內(nèi)營(yíng)養(yǎng)與腸外營(yíng)養(yǎng)在胃癌根治術(shù)后應(yīng)用效果比較[J]. 劉洪一,王白石,張加金,張秉棟,薛勇敢,賈寶慶.  中國(guó)腫瘤臨床. 2014(18)
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