食管癌术后早期肠内营养的临床观察和护理

The clinical observation and nursing of early postoperative enteral nutrition in esophageal cancer

目的探讨食管癌术后早期肠内营养对于术后恢复与炎症反应的影响,为合理选择护理方法提供参考。方法食管癌并可行根治性切除的80例患者随机分为治疗组和对照组各40例,对照组采用肠外营养治疗,治疗组采用肠内营养治疗。比较两组效果。结果所有患者均完成营养支持,无死亡与严重并发症患者,两组WT、IBW百分比、MAMC、握力等值比较,差异无统计学意义(P>0.05)。而治疗组TSF、CHI、尿氮等值均明显高于对照组(均P<0.05)。术前两组患者CRP、IL-6、TNF-α水平差异无统计学意义;术后两组患者CRP、IL-6、TNF-α水平均较术前明显上升,且治疗组上升幅度明显高于对照组(P<0.05)。结论相对于肠外营养,食管癌术后早期肠内营养更能有效改善患者的营养状况,减轻炎症反应,值得推广应用。

Objective To investigate the effects of postoperative recovery and the inflammatory response of early postoperative enteral nutrition in esophageal cancer for providing a reference for the reasonable choice of the nursing. Methods 80 cases of esophageal cancer were equally randomly divided into treatment group and control group, the control group were treated with parenteral nutrition therapy, the treatment group were treated with enteral nutrition therapy. The effect of two groups were compared. Results All patients completed the nutritional support that had no death and serious complications, WT, IBW percentage, MAMC and grip strength equivalent of two groups had no significant difference （P 〉 0.05）. But the TSF, CHI, urinary nitrogen in the treatment group were significantly higher （P 〈 0.05）. Before surgery, CRP, IL-6, TNF-al- pha level of two groups had no significant difference; after surgery, CRP, IL-6 and TNF-ct level of two groups were significantly increased, while the rising of the treatment group were significantly higher in the control group （P 〈 0.05）. Conclusion Compared with parenteral nutrition, early postoperative enteral nutrition in esophageal cancer is more effective to improve the nutritional status of patients and reduce the inflammatory response, which is worthy of being widely applied.