食管癌、贲门癌术后早期肠内营养临床应用.docVIP

食管癌、贲门癌术后早期肠内营养临床应用【摘要】 目的 探讨食管癌、贲门癌术后早期肠内营养的安全性、可行性和临床疗效。方法 选择56例食管、贲门癌手术患者。随机分为肠内营养组(EN组n=30)和肠外营养组(PN组n=26)，所有病例在术前、术后第1、8天分别测血清总蛋白、白蛋白、前白蛋白、转铁蛋白、淋巴细胞计数、尿素氮、肌酐、血糖、谷丙转氨酶、血红蛋白和电解质(k+、Na+、Cl-)。临床观察营养支持后有无消化道症状，胃肠功能恢复情况，有无吻合口瘘及测体质量。结果 所有病例在研究期间无死亡、无明显肝肾功能改变、无吻合口瘘。营养支持后EN组白蛋白、前白蛋白、转铁蛋白和淋巴细胞计数水平明显升高(P0.01)。营养支持后EN组与PN组对比，白蛋白、前白蛋白、转铁蛋白和淋巴细胞计数明显增高(P0.001)。临床观察生命体征及肛门恢复排气时间较PN组显著缩短时间(P0.001)，体质量下降减慢。结论 食管癌、贲门癌术后早期肠内营养安全可行，既能改善营养状态，维护和促进胃肠道功能，又能提高机体免疫功能，减少术后并发症的发生。 【关键词】食管癌；贲门癌；早期肠内营养 The clinical application of postoperative early enteral nutrition in patients with esophageal cancer and cardia cancer HUANG Shi-liang.Thoracic Surgery，Maoming Petrochemical Hospital，Guangdong 525000，China 【Abstract】 Objective To evaluate the effects of early enteral nutrition applied in patients with esophageal cancer and cardia cancer.Methods 56 pat-ients with esophageal cancer and cardia cancer undergone radical resection and reconstruction were randomly allocated into 2 groups (Entoral Nutrition group，EN group，n=30 and Parentoral Nutrition group，PN group n=26).Serum conce-ntrations of albumin，prealbumin were examined before operation and on the 8 th postoperative day; the electrolytes and nutritional status were observed; the postoperative complications were compared.Results The compilations in PN group (15.80%)were significantly higher than EN group (6.65%)，(P0.05) ;Compared with preparation，the concentration of prealbumin，serum albu-min transferrin and lymphocyte count were significantly increased after nutriti-onal support in EN group (P0.05).There was a significant difference in two groups.Conclusion Early enteral nutrition can improve the nutritional status of patien-ts with esophageal cancer or cardia cancer and reduce the occurrence of posto-perative complications; Application of postoperative early enteral nutrition in patients with esophageal cancer and cardia cancer is safe，effective. 【Key words】Esophageal cancer；Cardiac cancer surgery; Enteral nutrition 食管癌、贲门