食管癌术后早期肠内营养支持临床应用

Clinical application of early enteral nutrition support after esophagectomy

目的:探讨食管癌术后患者早期肠内营养(EN)的安全性及患者术后的恢复情况。方法:选取2014年1月-2015年12月55例食管癌择期手术患者,术后24 h应用短肽型肠内营养(百普力),胃肠功能恢复以后使用整蛋白肠内营养(能全力),观察其临床营养指标,包括:血清蛋白(AIb),前白蛋白(PA),转铁蛋白(TF),术后并发症,住院时间和营养相关费用等,在术前1天,术后第1天及术后第8天分别测定营养指标。结果:所有患者在研究期间无死亡,无严重并发症,无明显肝肾功能改变,术后第1天营养指标AIb,PA,TF均较术前下降,术后第8天此三项营养指标均高于术后第1天(P<0.05),其中4例出现腹胀,2例出现轻度腹泻,营养相关并发症发生率为10%,术后住院时间(10.7±1.3)d;营养费用(1500±100)元。结论:食管癌术后早期应用肠内营养安全可行,能改善患者的营养状况,免疫功能,减少住院时间,节省医疗费用。

Objective： To investigate the safety and postoperative recovery of early enteral nutrition（ EN） following esophagectomy.Methods： Clinical data of 55 patients with esophageal carcinoma who underwent esophagectomy during 2014 to 2015 were analyzed.They were supported with short peptide EN 24 h after the surgery. After the recovery of gastrointestinal function,the whole protein EN was used. Observation was carried out in terms of clinical nutrive indexes（ including ALB,PA,and TF）,postoperative complications,hospital stay and related nutrition fees. Nutritive indexes were measured on one day preoperatively,the 1st postoperative day and 8th postoperative day respectively. Results： No death,serious complications and obvious function change of liver and kidney occurred in all the patients. 4 cases suffered abdominal distension,2 suffered diarrhea and the incidence of nutrition related complications was 10%.Conclusion： Early application of EN after esophagectomy is safe and feasible. It has the advantage of improving patients＇ nutritional status and immune function. It can also shorten the hospital stay and decrease medical costs.