食道癌病人营养支持方法对康复的影响

The effect of nutritional support on the rehabilitation of patients with esophagus cancer

目的:观察不同营养支持方法对食道癌病人康复的影响,探讨食道癌病人围手术期科学、有效的营养支持方法,以提高疗效、减轻病痛、促进康复进程。方法:选择食道癌手术病人123例,根据家庭经济状况分为A组:术后肠内营养支持(22例),B组:术后肠内肠外营养联合应用(42例),C组:术前肠内营养5-7天加术后肠内肠外营养联合应用(59例),三组均于术后第一天开始给予营养支持,然后记录比较各组术后并发症及肠内营养适应性不良反应发生率、肠功能恢复时间、拔胸引管时间、术后住院天数、住院总费用指标。结果:术后并发症及肠内营养适应性不良反应,C组发生率最低,其次为B组,三组两两相比差异有统计学意义(p<0.05);肠功能恢复时间C组略早于A、B两组;拔胸引管时间C组最早,其次为B组,三组两两相比差异均有显著意义(p<0.05);术后住院天数C组最短,其次为B组,三组两两相比均有统计意义(p<0.05);住院总费用A组最少,B、C两组差别不大(p>0.05),A组与B、C两组比较有统计学意义(p<0.05)。结论:食道癌病人采用术前营养支持5-7天加术后肠内肠外营养联合应用的方法可有效减少术后并发症、减轻病人痛苦、缩短术后住院时间,并能实现病人住院费用的最优效价比。

Object To investigate the effect of nutrinational support on the rehabilitation of patients with esophagal cancer, and to research the scientific and effective nutritional support methed which can enhance the curative effect , alleviate suffering , stimulate rehabilitation process for patients with esophagal cancer in perioperative period. Method One hundred and twenty - three patients with esophagal cancer underwent surgery were divided into three groups according to economic conditions. A group： Enteral nutrition support conducted after surgery （22 cases） ; B group ： combination of enteral and pareteral nutrition support conducted after surgery （42 cases） ; C group： Enteral nutrition support conducted in 5 - 7 days before surgery plus combination of enteral and pareteral nutrition support conducted after surgery （59 cases）. The nutritional support was began from the first day after surgery , and the incidence of complications and adverse reactions , recovery time of bowel function, postoperative chest tube time, postoperative hospitalization time, hospital total cost were compared in all the three groups. Results The lowest incidence of complications and adverse reactions was found in C group, and then the B groups with statistical significance （ p 〈 0. 05） ; The recovery time of bowel function was a little earlier in C group than in A and B group; The postoperative chest tube time and postoperative hospitalization time were the shortest in C group , and then the B groups with statistical significance （p 〈 0. 05） ; The hospital total cost was the least in A group, but there is no signifacance in B and C group （ p 〉 0. 05）. Coclusion Enteral nutrition support conducted in 5 - 7 days before surgery plus combination of enteral and pareteral nutrition support conducted after surgery can reduce the incidence of complications and adverse reaction, alleviate suffering, shorten postoperative hospitalization time and realize the optimal titer than of the hospital total cost.