食管、贲门癌术后早期肠内营养的临床应用

Application of early enteral nutrition in postoperative patients with esophageal or cardiac cancer

目的探讨食管、贲门癌术后早期进行肠内营养的安全性、可行性和临床效果。方法80例行食管、贲门癌根治手术的患者随机分为肠内营养(EN)组和肠外营养(PN)组,术后第1天开始分别给予营养支持7d,于术前及术后第8天检测体重、血常规、肝功能,并观察肛门排气时间、住院时间、营养支持费用及并发症发生率。结果EN组术后红细胞、血红蛋白、白蛋白降低及白细胞、转氨酶升高的幅度均显著小于PN组(P<0.01)。EN组肛门排气时间明显早于PN组,营养支持费用显著少于PN组(P<0.01),术后并发症发生率显著低于PN组(P<0.05)。结论食管、贲门癌术后早期肠内营养支持是安全、可行、有效、经济的,较PN更具优势。

Objective To explore the safety, feasibility and clinical effects of early postoperative enteral nutrition for patients with esophageal or cardiac cancer. Methods Eighty patients with esophageal or cardiac cancer were randomly divided into two groups, and received enteral nutrition （EN）（n=40） or parenteral nutrition（PN）（n=40） continuously for 7 days after operation. The body weight, blood routine test, liver function on the 8th postoperative day were compared with those before operation. The time needed for anal exsufflation and hospital stay , cost of nutrition and morbidity of complication were also observed. Results Red blood cell count, the levels of hemoglobin and serum albumin decreased and white blood cell, transaminase increased less in EN group than those in PN group （P〈0. 01）. The time needed for anal exsufflation was shortened, and cost of nutrition was decreased significantly in EN group（P〈0. 01）. Postoperative complication rate was also decreased significantly in EN group compared with that in PN group（P〈0.05）. Conclusion Early postoperative EN for patients with esophageal or cardiac cancer is safer, more feasible, effective and economical than PN.