早期肠内营养对老年食管癌患者术后恢复的影响

Effect of Early Enteral Nutrition on Postoperative Recovery of Elderly Patients with Esophageal Cancer

目的研究早期肠内营养(EEN)在老年食管癌患者术后恢复中的作用。方法解放军第100医院2006年1月至2010年4月收治老年食管癌患者100例,均经术后病理检查证实。按不同的营养方式将患者分为早期肠内营养组(EEN组)和肠外营养组(PN组),每组各50例。EEN组男32例,女18例;平均年龄72岁。PN组男30例,女20例;平均年龄69岁。分析不同的营养方式对两组患者术后肠功能恢复情况、住院时间和并发症发生率及术后1周营养状况的影响。结果 EEN组肛门排气时间(45.3±12.7hvs.73.6±11.7h)、肛门排便时间(80.5±15.6hvs.140.1±13.2h)和住院时间(13.0±1.8dvs.15.2±3.3d)均短于PN组(P<0.05)。EEN组肺部感染、吻合口瘘、心脏并发症发生率明显低于PN组(P<0.05)。术后1周EEN组的血清白蛋白、外周血淋巴细胞、转铁蛋白、24h尿素氮均高于PN组(P<0.05)。结论与PN比较,EEN能促进老年患者术后代谢和功能恢复,降低并发症发生率,促进机体康复。

Objective To determine the effects of early enteral nutrition（EEN） on postoperative recovery in elderly patients with esophageal cancer.Methods We included 100 elderly patients with esophageal cancer who were admitted at the PLA 100 Hospital between January 2006 and April 2010,and whose diagnoses were confirmed by pathological examination.The patients were divided into an early enteral nutrition（EEN） group and a parenteral nutrition（PN） group,with 50 patients in each group.There were 32 males and 18 females with an average age of 72 years in the EEN group.There were 30 males and 20 females with an average age of 69 years in the PN group.We analyzed the effect of the nutrition administration method on bowel function recovery,hospital stay,complication rate,and nutritional status one week after surgery. Results The anal exhaust time（45.3±12.7 h vs.73.6±11.7 h）,time until anal defecation（80.5 h±15.6 h vs.140.1±13.2 h）,and hospital stay（13.0±1.8 d vs.15.2±3.3 d） in the EEN group were all shorter than those in the PN group（P〈0.05）.The rates of lung infection,anastomotic leakage,and cardiac complications in the EEN group were significantly lower than those of the PN group（P〈0.05）.One week after the operation,the serum albumin（ALB）,peripheral blood lymphocytes,transferrin,and 24 h urea nitrogen（BUN） in the EEN group were higher than those in the PN group（P〈0.05）.Conclusion Compared with parenteral nutrition,enteral nutrition can promote metabolic function in elderly patients after recovery,reduce morbidity,and promote recovery