肠癌手术中行早期肠内营养对患者术后营养状态的提高作用

Clinical effects of early enteral nutrition in patients after laparoscopic surgery for colorectal cancer

目的:探讨早期肠内营养对腹腔镜结直肠癌术后患者的影响.方法:采取回顾性方法对河北医科大学第四医院2012-01/2014-01接受治疗的108例结直肠癌患者的临床资料进行分析.所有患者均采用腹腔镜结直肠癌手术治疗.采用随机数表法将108例患者分为观察组和对照组,观察组患者术后给予早期肠内营养支持,对照组患者给予肠外营养支持.对比两组患者术前及术后7 d尿素氮(blood urea nitrogen,BUN)、总胆红素(total bilirubin,TBil)、白蛋白(albumin,Alb)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、血清总蛋白(total protein,TP)和前白蛋白(pre albumin,Pa)的变化,术后肛门排气时间、住院时间、住院费用和并发症发生率.结果:术后观察组患者在ALT、Alb和TP上的改变显著优于对照组患者,差异具有统计学意义(P<0.05).观察组患者术后的BUN、TBil、Pa较对照组患者差异不具有统计学意义(P>0.05).观察组患者术后肛门排气时间、住院时间显著少于对照组患者,所用营养费用显著低于对照组患者,比较两组间差异具有统计学意义(P<0.05).观察组感染性并发症发生率为3.70%,对照组感染性并发症发生率为5.55%.两组患者感染性并发症发生率比较,差异无统计学意义(P>0.05).并发症均经保守治疗治愈.两组均无死亡病例.结论:腹腔镜辅助式结直肠癌手术中早期肠内营养能够显著提高患者术后的营养状态,加快肠道功能的恢复,减少住院时间和营养费用,可以在临床上进一步地推广和使用.

AIM：To assess the clinical effects of early enteral nutrition in patients after laparoscopic surgery for colorectal cancer.METHODS：Clinical data for 108 patients who underwent laparoscopic surgery for colorectal cancer at the Fourth Hospital of Hebei Medical University from January 2012 to January 2014 were retrospectively analyzed.The patients were randomly divided into either an observation group or a control group.The observation group was given early postoperative enteral nutrition,and the control group was given parenteral nutrition support.Blood urea nitrogen（BUN）,total bilirubin（TBil）,albumin（Alb）,alanine aminotransferase（ALT）,serum total protein（TP） and prealbumin before and seven days after surgery,time to anal exhaust,hospital stay,hospital cost and morbidity were compared for the two groups.RESULTS：The changes in ALT,Alb and TP were significantly better in the observation group than in the control group（P 〈 0.05）.Postoperative BUN and TBil did not differ significantly between the two groups（P 〉 0.05）.The time to anal exhaust and hospital stay were significantly shorter and hospital cost was significantly less in the observation group（P 〈0.05）.The rate of infectious complications did not differ significantly between the two groups（3.70%vs 5.55%,P 〉 0.05）.Complications were cured after conservative treatment.There were no deaths.CONCLUSION：Early enteral nutrition in patients after laparoscopic-assisted surgery for colorectal cancer can significantly improve the nutritional status of patients,accelerate the recovery of bowel function,and reduce hospitalization time and nutritional costs.