早期肠内营养联合静脉营养在膀胱癌根治术后的应用

Application of early enteral nutrition combined with intravenous nutrition in radical resection of bladder cancer

目的探讨膀胱癌根治术后早期肠内营养联合静脉营养护理对患者术后营养恢复以及减少术后早期并发症的临床意义。方法纳入我院2016年1月～2018年3月因膀胱癌行全膀胱切除107例患者,其中术后行早期肠内营养EEN联合部分肠外营养PPN 55例,设为联合营养组,术后行完全肠外营养TPN 52例作为对照,设为TPN组。两组对比分析术前与术后的实验室营养指标变化、胃肠道功能恢复情况、早期并发症及术后住院天数。结果联合营养组患者在术后血红蛋白、白蛋白和前白蛋白方面与TPN组比较,无统计学差异(P>0.05),但肛门排气时间提早,术后早期并发症减少,平均术后住院天数缩短(P<0.05)。结论早期肠内营养联合静脉营养较完全肠外营养护理在改善术后患者机体的营养状况无明显差异,但有更快促进肠道功能的恢复、减少早期并发症以及缩短住院时间的优势。

Objective To investigate the clinical significance of early enteral nutrition combined with intravenous nutrition after radical surgery for bladder cancer on postoperative nutritional recovery and reduction of early postoperative complications.Methods A total of 107 patients who underwent total cystectomy for bladder cancer in our hospital from January 2016 to March 2018 were enrolled.Among them,55 patients with early enteral nutrition EEN combined with partial parenteral nutrition PPN after surgery were assigned to the combined nutrition group.And 52 cases of complete parenteral nutrition TPN after surgery were set as TPN group(control group).The preoperative and postoperative changes in laboratory nutritional indicators,gastrointestinal function recovery,early complications,and postoperative hospital stays between the two groups were compared.Results There were no significant differences in postoperative hemoglobin,albumin and prealbumin between the combined nutrition group and the TPN group(P >0.05).But the anal exhaust time of the combined nutrition group was earlier than that of the TPN group,the early postoperative complications were reduced,and the average postoperative hospital stay was shortened(P<0.05),compared with those of the TPN group.Conclusion Compared with complete parenteral nutrition,early enteral nutrition combined with intravenous nutrition has no significant difference in improving the nutritional status of postoperative patients,but it has the advantage of faster recovery of intestinal function,reduction of early complications and shorten of hospital stay.