食管贲门癌术后早期肠内营养.docVIP

食管、贲门癌术后早期肠内营养的临床应用 首席医学网 2008年10月10日 16:21:42 Friday 作者：姜建青，刘宝玉，张秀雄，俞永康，郑轶峰，郑山，杨列????作者单位：成都军区总医院心胸外科， 【摘要】? 目的 探讨早期肠内营养在食管、贲门癌术后的实施方法与临床效果。方法 对378例食管、贲门癌患者在术中留置鼻肠管或行空肠造瘘留置营养管，术后经鼻肠管或空肠造瘘管给予瑞素营养治疗。结果 所有食管、贲门癌术中均顺利留置鼻肠管或营养管，早期肠内营养患者吻合口瘘、肺部感染、胸腔感染、切口感染、术后胸胃排空障碍等并发症发生率较传统常规补液组明显减少，无一例死亡发生。术后肠鸣音恢复时间、肛门排气和排便时间明显缩短。结论 食管癌、贲门癌术后早期应用肠内营养，能促进胃肠功能恢复，改善患者营养状况，减少并发症，提高手术成功率。而且肠内营养支持简便、经济、无严重并发症，是临床手术后简便、安全、有效地营养补给方法。 【关键词】? 食管癌；贲门癌；肠内营养 　　Application of Early Enteral Nutrition for Patients with Carcinoma of Esophagus or with Cardiac Cancer after Operation 　　Jiang Jianqing, Liu Baoyu, Zhang Xiuxiong, Yu Yongkang, Zheng Yifeng, Zheng Xiushan, Yang Lie, 　　Chengdu Military General Hospital, Chengdu, Sichuan?? 610083 　　ABSTRACT? Objective?? To discuss the application of early enteral nutrition for patients with carcinoma of esophagus or with cardiac cancer after operation and the clinical effect. Methods? Nutrient canal was indwelt through the nasal-intestinal tube or by jejunum fistulation in the operation of 157 cases with carcinoma of esophagus or with cardiac cancer; after operation, Fresubin TP was given through the indwelt canal.Results? The nutrient canals were smoothly indwelt in all the patients; the complications such as anastomotic leakage, lung infection, infection in chest cavity, infection of incisional wound and obstacles in chest cavity and stomach evacuation in the patients receiving early enteral nutrition were much less than those in the patients receiving routine fluid infusion, no death occurred; the time for bowel sound recovery, anus aerofluxus and defecation after operation was much shorter.Conclusions? Early enteral nutrition for patients with carcinoma of esophagus or with cardiac cancer after operation can promote the recovery of gastrointestinal function, improve the nutriture of the patients, decrease the occurrence of complications and raise the successful rate of operation. 　　KEYWORDS?? carcinoma of esophagus cardiac cancer? enteral nutrition 　　食管