联合肠外营养与肠内营养治疗在食管癌术后的应用

Postoperative application of enteral nutrition combined with parenteral nutrition and total parenteral nutrition in patients with gastrointestinal cancer

目的 观察联合肠外与肠内营养治疗对食管癌患者术后营养状况的改善效果.方法 选取食管癌患者57例,术前用NRS2002进行营养筛查,术后通过联合肠外与肠内营养治疗,观察患者肠道耐受性和并发症,评价术后第1天和第7天营养指标（血清总蛋白、白蛋白、前白蛋白、血红蛋白、淋巴细胞计数）.结果 术前有39例患者存在营养不良风险,患者术后第1天与第7天比较,血清总蛋白水平差异无统计学意义（P＞0.05）,白蛋白、视黄醇结合蛋白、前白蛋白、白细胞、血红蛋白、淋巴细胞计数差异均有统计学意义（P＜0.05）.结论 NRS2002进行营养筛查可判定患者营养不良风险,联合肠外与肠内营养治疗可改善食管癌患者的营养状况.

Objective To investigate parenteral nutrition and enteral nutrition therapy for esophageal cancer patients nutritional status improvement.Methods Totally 63 patients with esophageal cancer were chosen,preoperative Nutritional Risk Screening 2002 （NRS2002） nutritional screening through joint after parenteral nutrition and enteral nutrition therapy.Patients with intestinal tolerability and complications after surgery on days 1 and 7 days nutrition indicators were observed,including total serum protein,albumin,prealbumin,hemoglobin,and lymphocyte count.Results Preoperative risk malnutrition occurred in 39 patients.Compared to patients on day 1 after the first 7 days,serum levels had no significant difference in total protein.Albumin,prealbumin,hemoglobin,and lymphocyte counts were significantly different statistical significance （P 〈 0.05）.Conclusions NRS2002 for nutritional screening patients at risk of malnutrition can be determined,and the combined parenteral and enteral nutrition therapies can improve nutritional status of patients with esophageal cancer.