早期肠内营养在腹腔镜辅助式结直肠癌术后应用的临床研究

Clinical study on early postoperative enteral nutrition following laparoscope-assisted colorectal cancer resection

目的探讨腹腔镜辅助式结直肠癌手术后早期肠内营养的必要性、可行性和有效性。方法回顾性分析予以开腹手术后早期肠内营养(OEEN组)、腹腔镜辅助式术后早期肠内营养(LEEN组)和腹腔镜辅助式术后胃肠外营养(LPN组)的结直肠癌患者60例,检测检测尿素氮(BUN)、丙氨酸氨基转移酶(ALT)、总胆红素(T-Bil)、血清总蛋白(TP)、白蛋白(Alb)和前白蛋白(Pa)的变化和术后胃肠道症状、首次排气时间和术后住院时间。结果 LEEN组在ALT、TP和Alb改变较其他两组相比有显著性差异(P<0.05);LEEN组首次排气时间为50.7±18.3h,少于OEEN组72.4±24.8h和LPN组68.2±26.5h,P<0.05有统计学差异;LEEN组术后住院时间(8±1.9d)明显较OEEN组(11.3±3.6d)缩短(P<0.05)。结论腹腔镜辅助式结直肠癌手术后早期肠内营养对于患者具有增强术后营养状态、加快肠道功能恢复、缩短术后住院时间等作用,值得使用和推广。

Objective To explore the necessity, feasibility and effectiveness of early postoperative enteral nutrition after laparoscope-assisted colorectal cancer resection. Methods Sixty cases with colorectal cancer were included in the study. Among them, 20 cases underwent open surgery and early postoperative enteral nutrition （Group OEEN）, 20 cases underwent laparoscope- assisted coloproctectomy and early postoperative enteral nutrition （Group LEEN）, and the others underwent laparoscope-assisted coloproctectomy and parental nutrition （Group LPN）. And the blood biochemical indicators and the clinical status were observed. Results There were significant difference in the changes of ALT, TP and Alb among the Group LEEN and other groups（P〈0.05）. In the Group LEEN, both the first exhaust time after operation and the postoperative hospitalization time was shorter than the other groups （P〈0.05）. Conclusion The early postoperative enteral nutrition following laparoscope-assisted colorectal cancer resection would enhance nutritional status, speed up recovery of gastrointestinal function and shorten the patient＇s recovery time after operation.