食管癌术后早期肠内营养应用及进展

Progress in the Application of Early Enteral Nutrition after the Operation of Esophageal Carcinoma

目的:研究食管癌术后早期肠内营养的应用及进展。方法将我科2013年收治的60例食管癌患者于术后第1d起进行营养指导,持续10 d,每日给予肠内营养的食谱排列,其中行空场造瘘的5例,行胃十二指肠营养管的40例,行空肠营养管的15例,所有患者均于术后第1 d常规缓慢滴注5%的葡萄糖氯化钠500 mL/d。第2 d起给予全流食,温度为38℃~40℃。并且逐步增加流食的种类,每增加一新种流食,先缓慢滴注2h后根据患者情况逐渐增快,术后3d内,肠内营养不足部分由卡文进行静脉补充,以后随肠内营养液输注量的增多,经静脉营养液逐渐减量至完全停用。结果80%的患者于术后第2 d排气,30%的患者有轻微腹胀。结论食管癌术后早期肠内营养能可以促进肠蠕动[1],显著增强患者术后的营养状况,降低患者并发症,促进患者康复。

Objective To study the application and progress of the early enteral nutrition after esophagectomy.Methods 2013 patients of 60 patients with esophageal nutrition guidance on postoperative day 1,for 10 days,ar ange daily to give enteral nutrition diet,which limits of colostomy in 5 cases,gastric duodenal nutrition tube(40 cases,15 cases of jejunum nutrition tube,al patients were on postoperative day 1 normal slow drip 5%glucose,sodium chloride,500 ml/day.2 day give ful liquid diets,temperature of 38~40℃.And gradual y increase the types of liquid diets,every increase a new liquid diets,slow drip first according to patients condition gradual y speed up after 2 hours,3 days postoperatively,enteral nutrition and shortfal s by Calvin intravenous supplement,enteral nutrition liquid infusion quantity increasing,after transvenous nutrient solution gradual y reduced to completely stop.Results 80%of the patients in the postoperative exhaust 2 day,30%of the patients with mild abdominal distension.Conclusion Early enteral nutrition after esophagectomy can can promote intestinal peristalsis[1],markedly enhance patients with postoperative nutritional status,reduce patient complications,promote patients recover.