喉癌术后患者的营养支持

Nutritional support post-layngectomy

目的 :探讨喉癌术后患者营养支持方式、供给量 ,以及营养支持对患者术后康复的影响。方法 :将 2 85例喉癌患者随机分为观察组和对照组 ,观察组 16 1例给予匀浆膳食 ,对照组 12 4例给予混合奶 ,均采用硅胶鼻胃管每日鼻饲 5～ 6次 ,检测术前、术后 7天、术后 14天各项营养指标 ,观察咽瘘发生的例数和平均住院日。结果 :经统计学处理 ,观察组各项营养指标下降程度明显低于对照组 ,观察组平均住院日比对照组缩短 12天左右。两组咽瘘发生率之间差异有统计学意义。结论 :喉癌术后患者采用匀浆膳食营养支持方式较为适宜 ,合理的营养支持可降低咽瘘发生率 ,缩短平均住院日 ,减轻患者的经济负担。

Objective:To provide the basis for postoperative nutritional support,explore the appropriate support methods and its influnce on rehabilitation in postoperative patients with laryngeal carcinoma.Methods:285 patients with laryngeal carcinoma were randomly divided into therapy group and control group.The therapy group (161 patients)was given homogenate diet and the control group(124 patients) was given mixed milk by nasal feeding 5-6 times per day.The nutritional index and occurrence of pharyrgeal fistula were monitored at preoperation,7th and 14th days postoperation respectively.The duration of hospitalization of each patient was recorded at the same time.Results:The decreasing of the nutritional index was significantly lower in the therapy group than in the control group( P <0.05).The duration of hospitalization was shortented to about 12 days, and the incidence of pharyngeal fistula was reduced to 11%.Conclusion:The appropriate nutrition may decrease the incidence of pharyngeal fistula,shorten the mean duration in hospital and reduce the economic burden of postoperative patients with laryngeal carcinoma. Author's address Department of ENT-HN,the Third teaching hospital of Norman Bethune University of Medical Science,130031