食管贲门癌术后早期营养管的临床应用.docVIP

食管贲门癌术后早期营养管的临床应用 [摘要] 目的：分析食管、贲门癌术后早期肠内营养支持，对维持机体营养，预防术后并发症的作用。方法：回顾1353例食管、贲门癌患者随机分成两组，肠内营养组(EN组)与肠外营养组(PN组)。EN组均采取术中放置营养管，术后第1天开始行肠内营养。PN组术后第1天开始行静脉营养支持。监测两组患者术前1d、术后5d、术后8d的体质量，血浆白蛋白，尿素氮以及术后出现的并发症。结果：两组患者在体质量、血浆白蛋白上无差异。在术后预防并发症发生方面， EN组优于PN组(P0. 01)。结论：食管、贲门癌术后早期肠内营养支持，可明显降低术后并发症的发生，改善患者营养状况，并且费用低廉给患者带来获益。 [关键词] 食管肿瘤；贲门肿瘤；肠道营养；手术后并发症 Clinical application of enteral nutrition tube early after operation of esophagus and cardia carcinoma HUANG He-ping＊ NING Cheng-dong CHENG Min-jing PAN Yu ＊Department of Cardiac and Thoracic Surgery, the affiliated Lu’an hospital , Anhui medical university, Lu’an 237005,China Corresponding author: HUANG He-ping,Email:peacehuang@126.com 作者单位：237005 安徽医科大学附属六安医院胸心外科（黄和平 宁成栋 程明锦 潘宇） 通讯作者：黄和平，Email：peacehuang@126.com [Abstract] Objective: To study the effects of early postoperative enteral nutrition support on nutritional parameters specifically on prevention of postoperative complications for patients with esophagus and cardia carcinoma. Methods: One thousand three hundred and fifty three patients were randomly divided into 2 groups: enteral nutrition (EN) support group and parenteral nutrition (PN) support group. The duodenal or jejunal feeding tubes were placed during surgery in patients in EN group who received nutritional support from day1. The patients in PN group received nutrition support through vein on day 1 after surgery. The body weight， the level of plasma albumin and urea nitrogen， and the postoperative complications were monitored on day 1 before operation and on day 5 and day 8 after operation. Results: There was no difference between the two groups in body weight and the level of plasma albumin. EN was better than PN in prevention of postoperative complications (P0.01). Conclusion: Early postoperative enteral nutrition support significantly decreased the occurrence rate of postoperative complications and improved the nutritional parameters with low cost for patients with esophagus and cardia carcinoma. [Key words] Eso