肾癌根治术后早期肠内营养对患者肠道功能及应激反应的影响

The Influence of Early Postoperative Enteral Nutrition on Recovery of Intestinal Function in Patients With Radical Nephrectomy

目的探讨早期肠内营养对肾癌根治术后肠道功能恢复的影响。方法采用回顾性分析法,对本院2007年5月～2011年5月收治的52例肾癌患者为观察组,于术后开始实施肠内营养;同时选取2003年5月～2007年5月未实施肠内营养的45例肾癌患者为对照组,比较两组患者治疗前后血清白蛋白、前白蛋白、C反应蛋白(CRP)、白细胞介素6(IL-6)水平及通气、通便时间和拆线时间。结果观察组患者的前白蛋白水平明显高于对照组(术后禁食患者),通气、通便时间短于对照组(P<0.05),CRP和IL-6均低于对照组(P<0.05),而总蛋白、白蛋白以及拆线时间相比差异无显著性(P>0.05)。结论早期肠内营养能较早恢复患者的肠道功能,缩短肠道通气、通便的时间,同时减少了机体的炎性因子释放,降低了应激反应程度,是一种安全有效、可改善患者术后病情的理想治疗方法。

Objective To evaluate the influence of early enteral nutrition on intestinal function recovery after radical nephrectomy.Methods A retrospective study was analyzed between May 2007 and May 2010,52 cases of renal cell carcinoma patients received enteral nutrition after the operation.And 45 cases of patients without enteral nutrition were selected as control during May 2004 to May 2007.Total protein,albumin,prealbumin and C-reactive protein（CRP）,IL-6 were detected before and after the operation.Suture removal time and the time of defecation and exhaust were also observed. Results The level of prealbumin was higher than that in control group（fasting patients after the operation）,and the CRP and IL-6 level was lower,the time of defecation was shortened（P0.05）.There were no significant difference in the two groups for total protein,albumin and the suture removal time（P0.05）.Conclusions Early enteral nutrition can recover as early as intestinal function for patients,shorten the time of defecation and exhaust,reduce the incidence rate of adverse reactions including diarrhea,malnutrition and inflammatory cytokines release.It is a safe and effective treatment which can improve the patients postoperative condition.