自制非要素膳在食管、贲门癌术后早期肠内营养中的运用

Clinical application of enteral nutrition with selfcontrol non-elemental diet in operation on esophageal and cardiac cancer

目的探讨食管、贲门癌术后早期应用自制非要素膳进行肠内营养的安全性、可行性和临床效果。方法 99例行食管、贲门癌根治术的患者随机分为自制非要素膳肠内营养(enteral nutrition,EN)组和肠外营养(parenteral nutrition,PN)组,两组均于术后第1天开始给予营养支持或静脉营养,分别于术后第1天、第8天测定营养相关指标并进行比较,对术后并发症发生率、营养支持费用、肠道功能恢复时间以及平均住院天数等临床相关指标进行分析。结果术后第8天两组患者的血清总蛋白、白蛋白、前白蛋白和淋巴细胞计数在营养支持后均升高,EN组升高较PN组更为显著(P<0.05);肠外营养组并发症发生率也高于肠内营养组(P<0.05)。营养支持费用、肠道功能恢复时间以及平均住院天数等比较,肠内营养组均优于静脉营养组(P<0.05)。结论食管、贲门癌术后自制非要素膳行早期肠内营养支持是安全可行、有效、经济的,较PN更具优势。

Objective To explore the safety,feasibility and clinical effects of early postoperative enteral nutrition with selfcontrol non-elemental diet for patients with esophageal or cardiac cancer. Methods 99 patients with esophageal and cardiac cancer were randomly divided into enteral nutrition group with selfcontrol non-elemental diet （EN）（n=52）and parenteral nutrition group（PN） （n=47）. The first day in both groups after the operation began to give nutritional support or parenteral nutrition, respectively, After the day 1 and day 8,determination of nutrition-related indicators were compared among the groups. The incidence of postoperative complications, cost of nutrition, intestinal function recovery time, and the average days of hospitalization related indicators such as clinical analysis. Results After 8 days,the serum albumin, total protein, prealbumin and lymphocyte count were increased after nutritional support in both groups, while these were increased more in EN group than that in PN group （P〈0.05）. Postoperative complication rate was also decreased significantly in EN group than that in PN group （P〈0.05）,cost of nutrition,intestinal function revovery time, and the average days of hospitalization and other comparison, the EN group were superior to PN group （P〈0.05）. Conclusion Early postoperative enteral nutrition with selfcontrol non-elemental diet for patients with esophageal and cardiac cancer is safe, more feasible,effective and economical than parenteral nutrition.