食管癌切除术后早期肠内营养临床探究及护理.docVIP

食管癌切除术后早期肠内营养临床探究及护理[摘要] 目的:探讨食管癌术后早期应用肠内营养（EN）支持及护理的方法。方法：190例食管癌患者行食管次全切除加胃-食管颈部吻合术，术中行鼻肠管留置，术后24 h起予EN制剂百普力，并行相应护理。分别于术后EN前及EN的第5、9天检测患者的血生化及营养指标，观察患者营养支持期间有无腹痛、腹胀、恶心、呕吐、腹泻等胃肠道不良反应。结果：所有患者术中均常规操作置入鼻肠管，未发生因导管留置引起的任何并发症；全组患者均能耐受早期EN，无一例发生严重并发症。EN后营养评定指标白蛋白、转铁蛋白及前白蛋白水平较EN前有显著差异（P＜0.05），体重、血红蛋白、丙氨酸转氨酶及总胆红素无显著差异（P＞0.05）。结论：食管癌术后早期予EN可有效改善患者营养状况，规范化护理措施是保障EN顺利完成的关键，可有效减少并发症的发生。 ［关键词］ 食管肿瘤； 肠内营养； 护理 ［中图分类号］ R735.1; R459.3 ［文献标识码］ A ［文章编号］ 1671-7562（2011）01-0022-04 doi:10.3969/j.issn.1671-7562.2011.01.省略 Clinical investigation of postoperative early enteral nutrition in patients after esophagogastrostomy and its nursing care MEI Yan-ping, LIU Hong-zhen, GAO Hong-mei, JI Yong （Department of Cardiothoracic Surgery, Jiangyin People’s Hospital, School of Medicine, Southeast University, Jiangyin 214400, China） ［Abstract］ Objective： To investigate the method and effect of early enteral nutrition applied in patients with esophageal cancer and to summarize nursing experiences. Methods： 190 patients with esophageal cancer had a naso-jejunal tube inserted during the operation and received early enteral nutrition after operation. Peptison were infused 24 hours since the postoperative day. Serum concentration of albumin, prealbumin were examined before enteral nutrition and on the 5th and 9th postoperative day. The recovery of bowel movement and other digestive symptoms such as abdominal pain, distension, diarrhea, nausea and vomiting were observed during the period of study. Results： The concentration of prealbumin, serum albumin, prealbumin and transferrin were significantly elevated after nutritional support in EN group（P＜0.05）. No severe complications occurred. However, body weight, Hb and the serum level of ALT and TBIL showed no significant changes（P＞0.05）.Conclusion： Early enteral nutrition can improve the nutritional status of patients with esophageal cancer and reduce the occurrence of serious postoperative complication. Early postoperative entera