早期肠内营养在上消化道肿瘤术后应用

The application of early enteral nutrition after the upper gastrointestinal tract tumor operation

目的:探讨上消化道肿瘤术后早期肠内营养(early enteral nutrition,EEN)支持的效果。方法:对64例上消化道肿瘤患者(EEN组)于术后24 h经鼻营养管注入要素饮食,并与同期56例术后按传统肠外营养(PN组)支持进行比较;观察2组患者前1天及术后第6天的血清白蛋白(ALB)和前白蛋白(PA)水平,术后肛门排气时间,以及早期肠内营养过程中发生相关并发症及术后并发症。结果:术前2组患者ALB、PA水平差异无统计学意义(P>0.05);2组术后第6天ALB、PA水平均较术前明显下降(P<0.01),但PN组的下降程度均明显高于EEN组(P<0.01)。EEN组术后肛门排气时间明显早于PN组(P<0.01);EEN组术后并发症发生率为13.4%,明显低于PN组的34.2%(P<0.01)。结论:上消化道肿瘤术后行EEN支持是安全、可靠的,促进患者术后早期胃肠道功能恢复,保护肠黏膜正常吸收、消化功能,减少术后患者输液负荷。

Objective： To explore the effects of early enteral nutrition（EEN） on the nutritional support of postoperative patients with upper gastrointestinal tract tumor.Methods： Sixty-four and 56 cases with upper gastrointestinal tract tumor were treated with elemental diet through nasointestinal tube（EEN group） and traditional parenteral nutrition（PN group） at 24 h after operation,respectively.The levels of serum albumin（ALB） and prealbumin（PA） in two groups were observed at 1 day before operation and 6 days after operation.The time of the first time postoperative gastrointestinal exhaust,the related complication during the period of early enteral nutrition and postoperative complication were observed.Results： The preoperative levels of ALB and PA in two groups were not statistic significance（P 0.05）.The postoperative levels of ALB and PA in two groups decreased obviously,the decreasing degree of PN group was higher than that in EEN group（P 0.01）.The time of the first postoperative gastrointestinal exhaust in EEN group was earlier than that in PN group（P 0.01）.The incidence of postoperative complication in EEN group（13.4%） was significantly lower than that in PN group（34.2%）（P 0.01）.Conclusions： The EEN is safe and effective in the nutritional support of postoperative patients with upper gastrointestinal tract tumor.Promoting the patient gastrointestinal function early recovery and protecting intestinal mucosa normal digest function can reduce the postoperative patient infusion load.