胃肠道肿瘤术后早期肠内营养支持起始治疗时间临床分析

Starting Treatment Time of Early Postoperative Enteral Nutrition Support in Patients with Gastrointestinal Cancer

目的:探讨胃肠道肿瘤手术后早期肠内营养支持的最佳起始时间。方法:胃肠道肿瘤术后患者100例作为研究对象,随机分为Ⅰ组,Ⅱ组,Ⅲ组和Ⅳ组,分别于术后6h、12h、24h、48h开始给予肠内营养支持。结果:4组肠内营养支持阶段,血压、脉搏、呼吸、血氧饱和度等均无大幅度波动。4组组间比较,肠蠕动恢复时间,首次肛门排气时间和腹部不适发生率有显著性差异(t=18.347,P<0.01;t=21.586,P<0.01;χ2=7.864,P<0.05)。肠内营养支持开始时间越早,肠内功能恢复时间越短,但腹部不适发生率也最高。结论:综合有效性和安全性考虑,我们认为,术后12h开始给予肠内营养支持是相对合理的,值得临床进一步研究。

Objective：To explore the best beginning time of EN at early stage for tumor surgery of gastrointestinal tract.Methods：100 cases of patients as studied object were randomly divided intoⅠgroup,Ⅱgroup,Ⅲgroup and Ⅳgroup,and given EN at 6h,12h,24h and 48h after surgery respectively.Results：Blood pressures,pulse,breathe and oxyhemoglobin saturation between 4 groups had no significant difference.Time of peristalsis recover,time of pass gas and rate of abdominal discomfort showed significant difference（t=1 8.347,P〈0.01;t=21.586,P〈0.01;χ2=7.864,P〈0.05）.The more early time of beginning time of EN was,the less the time of enteral function needed and the more abdominal discomfort happened.Conclusion：Considering from effect and safety,we think that begin EN at 12h after surgery was relatively fit,and deserving study further in clinical work.