早期肠内营养在结肠癌术后恢复中的作用研究

Effect of early enteral nutrition on postoperative recovery in patients with colon cancer

目的 探讨早期肠内营养在结肠癌手术患者中的临床应用.方法 将结肠癌患者90例按数字表法随机分为肠内营养组、留置胃管组及对照组,每组30例.对照组常规治疗,留置胃管组给予术后间断夹闭胃管并给予肠内营养,肠内营养组术后早期给予拔除胃管同时给予肠内营养.观察术后排气、排便时间、术后住院时间及营养学指标.结果 术后三组之间排气时间、排便时间、术后住院时间差异有统计学意义[肠内营养组：（50.07±11.59）h、（76.75±27.37）h、（10.11±1.57）d;对照组：（62.03±12.31）h、（90.67±25.64）h、（11.80±1.83）d;留置胃管组：（43.53±11.94）h、（61.17±22.67）h、（8.70±1.53）d;均P＜ 0.05],留置胃管组住院时间最短,术后排气、排便最早.术后1周患者血红蛋白、血浆清蛋白在留置胃管组、肠内营养组与对照组间差异有统计学意义（均P＜0.05）,三组术后与术前相比均有不同程度下降,但术后留置胃管组与单纯营养组间差异无统计学意义（P＞0.05）.结论 结肠癌患者术后留置胃管并同时给予肠内营养是合理的选择.

Objective To investigate the clinical application of early postoperative enteral nutrition in patients undergoing colon cancer operation.Methods 90 patients suffering from colon cancer were randomly divided into the enteral nutrition group,indwelling stomach tube group and the control group.The control group was given conventional treatment and the indwelling gastric tube group was received postoperative intermittent clamping of stomach tube and enteral nutrition.Moreover,patients in the enteral nutrition group were pulled out the tube on the first postoperative day while giving enteral nutrition.All patients were observed for exhaust defecation time,length of hospital stay postoperative and nutrition indicators.Results Exhaust defecation time,length of hospital stay postoperative had significant difference among three groups.Indwelling stomach tube group set minimum length of stay and first passage of flatus and defecation in the three groups [the enteral nutrition group：（50.07±11.59） h,（76.75±27.37） h,（10.1 1±1.57） d,the control group：（62.03±12.31） h,（90.67±25.64） h,（11.80±1.83） d,indwelling stomach tube group：（43.53±11.94） h,（61.17± 22.67） h,（8.70±1.53） d （P ＜ 0.05）].The levels of hemoglobin and plasma albumin one week after operation were statistically lower than pre-operation,while that the level of these nutrition indicators were higher in indwelling stomach tube group compare to control group （all P ＜ 0.05）.The same result was observed between enteral nutrition group and control group.Whereas,the change of nutrition indicators between the enteral nutrition group and the control group was not statistical significant （P ＞ 0.05）.Conclusion Indwelling stomach tube combined with enteral nutrition is a reasonable choice for patients after colonic cancer surgery.