| Summary: | 碩士 === 臺北醫學大學 === 保健營養學系 === 94 === This study investigated the support of total parental nutrition (TPN) given pre-operatively to the patients with gastric cancer. The nutritional intervention was evaluated through the surgical jejunostomy as a route of early enteral feeding to provide sufficient enteral nutrition in gastric cancer patients. The patients received TPN one week prior to operation, and early enteral feeding through jejunostomy feeding on the first day of post-operation. The patients were observed for 14 days post-opreation and followed up after 3-week discharge. The subjects (n = 10) with the average age of 74.3 years old lost weight by 12.4% in the recent 6 months prior to operation. Their caloric requirement in average was 1635.6 kcal, which approximately equals to 30.3 kcal/kg body weight (BW). Protein requirement in average was 1.2 g/kg BW. The use of TPN was 19.6 days in average. There were 6 patients having bloating and 3 patients having diarrhea after receiving early enteral feeding. However, abdominal cramps, vomiting, and aspiration pneumonia had not occurred. The average body weight tended to decrease after 3-week discharge compared with that prior to operation. The support of TPN at least for 7 days in gastric cancer patients with significant weight loss and severe malnutrition going to receiving operation maintained the nutritional status and prevented continuous weight loss. The early enteral feeding through jejunostomy tended to increase serum hemoglobin, hematocrit, and iron levels to prevent deterioration from anemia. Additionally, nutritional support gradually improved the immune function of gastric cancer patients by increasing total lymphocyte counts. The nutritional care had better be continuously evaluated to prevent the occurrence and deterioration from malnutrition in gastric cancer patients with gastrectomy.
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