老年食管贲门癌术后早期肠内营养与肠外营养疗效的对比研究

Clinical comparative study of postoperative early enteral nutrition and parenteral nutrition in elder patients with esophageal and cardiac cancer

目的:探讨术后早期肠内营养(EEN)在老年食管贲门癌病人中的临床价值。方法:将102例老年食管贲门癌病人随机分为术后EEN组51例,全肠外营养(TPN)组51例,分别在术前和术后第8天测定病人的体重、血清清蛋白(ALB)、前清蛋白(PA)、总胆红素(TBIL)和谷氨酰转肽酶(GGT)等,观察肛门排气时间、并发症发生率和治疗费用情况。结果:术后第8天,EEN组病人的体重下降明显少于TPN组(P<0.05),血清PA水平高于TPN组(P<0.05),TBIL、GGT指标低于TPN组(P<0.05),肛门排气时间短于TPN组(P<0.05),术后营养相关费用和术后非营养治疗费用少于TPN组,平均住院时间短于TPN组(P<0.05)。结论:老年食管贲门癌病人术后EEN对肝功能影响小,在改善营养状况、促进胃肠功能恢复、减少感染并发症和降低治疗费用方面明显优于TPN。

Objective：To compare the clinical value of early enteral nutrition（EEN） with total parenteral nutrition（TPN） in postoperative elder patients with esophageal and cardiac cancer. Methods： 102 cases of postoperative elder patients with esophageal and cardiac cancer were randomly divided into EEN group（n=51）and TPN group（n=51）.The weight loss,serum albumin, prealbumin,liver function were measured before operation and on the eighth day after operation. The anal exsufflation time, infectious complication, duration of hospital stay and treatment cost were observed. Results： The weight loss in EEN group were less than those of TPN group（P0.05）. The levels of ALT, AST, BIL and GGT in EEN group on the eighth day after operation was lower than those in TPN group（P0.05）. The anal exsufflation time and duration of hospital stay in EEN group were shorter than those of TPN group（P0.05）. The treatment cost of EEN group was significantly less than that of TPN group（P0.05）. The infectious complication rate of EEN group was lower than that of TPN group（P0.05）. Conclusion： EEN in postoperative elder patients with esophageal and cardiac cancer can decrease the postoperative infectious complication and the treatment cost, shorten the duration of hospital stay, improve nutritional status and recovery of gastrointestinal function with less side effects of liver function.