目的评价不同时间行肠内营养对全腔镜食管癌切除术后患者的影响.docVIP

李伟：女，本科，主管护师，E-mail： 李伟：女，本科，主管护师，E-mail： 714095760@ 李伟 陈克清 范少芳 林娟 福建医科大学附属协和医院胸外8区 350001 [摘要]???目的 评价不同时间开始行肠内营养对全腔镜食管癌切除术后患者的影响，探讨全腔镜食菅癌术后肠内营养支持的最佳时机。方法 将50例行全腔镜食管癌术后患者随机分成两组，实验组24例于术后8—12小时内给予肠内营养，对照组26例于术后24—48小时给予肠内营养。测定入组患者术前一天、术后第五天、第八天血生化主要营养指标（总蛋白tp、白蛋白alb），临床观察营养支持后有无消化道症状及术后并发症。结果 术前一天实验组与对照组总蛋白、白蛋白没有差异，实验组与对照组治疗前后总蛋白、白蛋白变化水平的差别有统计学意义（P0.05）；术后第五天实验组的总蛋白(tp)和白蛋白（alb）高于对照组，术后第八天实验组的总蛋白(tp)和白蛋白（alb）高于对照组，两组比较差别均有统计学意义（P0.05）；术后并发症比较无统计学意义（???1.36，P=0.243）；术后胃肠道不适症状实验组多于对照组，有统计学意义（P=0.036）。结论 两个时间段进行肠内营养，均能不同程度改善患者的营养状况。 [关键词]? 全腔镜 食管癌?? 早期 肠内营养?? ?时机 [ 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）.Conclusions: Giving enteral nutrition on two tim