全腔镜食管癌切除术后早期肠内营养时机及效果探讨.doc

全腔镜食管癌切除术后目的 评价不同对食管癌切除术后患者的影响探讨食菅癌术后肠营养支持的。方法将例行食管癌术后患者随机分成组，给予肠内营养。测定临床观察营养支持后有无消化道症状术后并发症。结果[ Abstract ]Objective: To evaluate the effect of giving enteral nutrition in different time for the patients with esophageal carcinoma after the complete video-assisted thoracoscopic esophagectomy, and explore the best time of giving enteral nutrition after esophagectomy.Methods: 50 patients with esophageal carcinoma were randomly divided into two groups. The experimental group with 24 patients received enteral nutrition in 8 to 12 hours. And the control group with 26 patients received enteral nutrition in 24 to 48 hours. We measured their major biochemistry nutritional indicators ( total protein, albumin) ?the day before surgery and on the fifth and eighth day after surgery, and we clinically observed whether gastrointestinal symptoms and complications would occur. Results: One day before the surgery, there is no difference between Experimental Group(EG) and those of Control Group(CG) of Total Protein(TP) and Albumin(Alb). (P0.05). Five days after the surgery, TP and Alb of EG is higher than those of CG (P0.05). Eight days after the surgery, TP and Alb of EG is higher than those of CG, too (P0.05). The difference of post-surgical complication between the two groups is not statistically significant（((=1.36，P=0.243）, while gastrointestinal disorder symptom of EG is more frequent than that of CG （P=0.036）.Conclusion: Giving enteral nutrition on two time periods( in 8 to 12 hours and 24 to 48 hours) both can improve patients nutritional status. Giving enteral nutrition in 8 to 12 hours is better to improve the nutrition status, but causing more gastrointestinal discomforts. There is no difference of complications occured in the two groups. ? 全腔镜下食管癌切除术后,因消化道重建,短期内患者无法正常进食,且因肿瘤对消化道及机体的影响,多数患者术前已存在不同程度的营养不良,手术创伤和应激使机体处于高分解代谢状态,又加剧了营养不良,故对食管癌术后患者营养支持十分必要。食管癌术后开展早期营养已成为医学界的共识，但在术后何时开始营养支持及营养支持的途径方面的意见并不统一[1]各研究均未对早期肠内营养界以准确的时间，为寻求食管癌术后最佳的肠内营养时机，通过实验比较各时间段进行肠内营养的效果，为临床营养护理提供