食管癌术后颈部吻合口瘘不同途径营养支持.pdfVIP

中 国临 床 营 养 杂 志 CHINESE JOURNAL OF CLINICAL NUTRffION · 论 著 · 食管癌术后颈部吻合口瘘不同途径营养支持 张德荣# (福建省肿瘤医院胸外科，福州350014) 摘要：目的 分析食管癌三野术后颈部吻合口瘘不同途径营养支持。方法 将54例食管癌术后3～14天并发颈 部吻合口瘘患者根据营养支持途径分为肠内营养组和肠外营养组，观察颈部吻合口瘘愈合时间、营养指标、肝功能的 变化。结果 52例瘘口愈合，2例继发纵隔感染死亡。两组平均愈合时间相似，肠内营养组瘘愈合后第1天血转铁蛋白 较肠外营养组显著增加 (P0．05)。肠外营养组瘘愈合后第1天肝功能指标较瘘发生第1天和肠内营养组瘘愈合后第1 天均显著升高 (P0．05)。肠内营养组肝功能无波动。结论 肠内营养作为吻合口瘘治疗基础，能够提高机体蛋白合 成，保护肝脏功能，同时经济方便。 关键词：肠内营养；肠外营养；食管胃吻合口瘘；食管癌 中图分类号：R730．5 文献标识码：A 文章编号：1008-5882(2008)03．0156．04 Alternative Routes of Nutritional Supply for Postoperative Neck Anastomotic Leakage in Patients with Esophageal Carcinoma ZHANG De．rong (Department ofThoracic Surgery，Fujian Provincial Tumor Hospital，Fuzhou 350014，China) objective To evaluate different routes of nutritional suppo~for neck esophagogastric anastomotic leak following three-field dissection in patients with esophageal carcinoma．Methods Fifty-four patients developed a confirmed neck leak on day ranging from 3 to 1 4 days following surgery．All patients with anastomotic leak were divided into two groups：enteral nutrition(EN)group and total parenteral nutrition(PN)group．Both groups received otherwise same treatments．The mean healing time，nutritional status，and hepatic function were recorded．Results Fifty-two patients were cured and 2 patients died of subsequent severe mediastinal in- fections．The mean healing time was similar between two groups．On the day after the healing，serum transfer- rin level in EN group was significantly higher than that in PN grou