结肠癌术后早期肠内营养的应用价值

Effect of early enteral nutrition on the recovery and stress reaction after operation of colon carcinoma

目的探讨结肠癌术后早期肠内营养（EN）的临床应用价值。方法93例结肠癌患者按入院单双号分为EN组（57例）和肠外营养组（PN组，36例），EN组于结肠癌术后24h内开始经空肠营养管滴人肠内营养制剂并逐步减少静脉营养支持，PN组于结肠癌术后每日行完全肠外静脉营养支持，直到经口进食。观察两组胃肠功能恢复时间、营养状况及血清C-反应蛋白水平变化情况。结果两组术后营养状态指标均较术前明显下降，但两组间差异无统计学意义（P〉0．05）；EN组肛门排气时间、排便时间分别为（52．9±17．6）h和（67．2±9．3）h，与PN组的（71．4±13．8）h和（83．6±10．1）h相比较，差异均有统计学意义（t=2．58、3．56，均P〈O．05）；术后7dEN组C-反应蛋白水平（19．3±2．2）mg／L明显低于PN组的（27．8±2．3）mg／L（t=4．12，P〈0．05）。结论早期EN能降低结肠癌术后应激反应，促进胃肠功能的早期恢复。

Objective To observe the effect of early enteral nutrition on the recovery and stress reaction after the operation of colon carcinoma. Methods 93 patients with colon carcinoma were divided into enteral nutrition group and parenteral nutrition group. Patients of EN group were given nutrition preparation through the jejunal nutrient canal beginning in the first day after operation and reduced the venous support gradually. Those of PN group were given parenteral nutritional supports from the the first day after operation until oral feeding. Results There were no significant differences between the EN group and PN group in the nutritional status. Both the first postoperative anoretum exhaust time and defecation time （52. 9 ± 17. 6; 67.2 ± 9. 3 ） h in group EN were less than that （ 71.4 ± 13.8 ; 83.6 ± 10. 1 ） h in group PN,there were significant differences between two groups（t =2. 58,3.56,all P 〈0. 05）. The CRP in EN group af- ter operation was obviously lower than preoperatiun （ P 〈 0. 05）. Conclusion The early enteral nutrition could lower the stress reaction and promote the recovery of gastrointestinal tract function.