鼻饲流质结合护理干预对食管癌患者术后营养状况的改善作用

Improvement of postoperative nutritional status by nasal fluid feeding combined with nursing intervention in patients with esophageal cancer surgery

目的研究食管癌术后患者进行肠内营养(EN)支持结合早期鼻饲流质并进行护理干预,对食管癌术后患者营养状况的影响。方法采用随机数表法将96例接受食管手术的患者分为研究组和对照组,每组48例。研究组患者给予鼻饲EN乳剂,同时早期鼻饲流质和护理干预;对照组单独给予鼻饲EN混悬液及常规护理。采用PG-SAG量表评估两组患者术前和术后第7天的营养相关指标(血红蛋白、尿素、白蛋白、前白蛋白和总胆固醇)。结果两组患者的年龄、性别构成、术后EN开始时间、平均住院天数、围手术期并发症发生率比较,差异均无统计学意义(P>0.05)。虽然术后第7天两组患者的营养相关指标均较术前下降,但研究组的血红蛋白、尿素、白蛋白、前白蛋白和总胆固醇浓度均显著高于对照组,差异有统计学意义(t=6.836,P=0.009;t=6.503,P=0.012;t=4.492,P=0.028;t=5.073,P=0.020;t=6.082,P=0.018)。结论鼻饲流质结合护理干预辅助EN能较好地改善食管癌患者围手术期的营养状况,促进术后康复。

Objective To investigate the effects of enteral nutrition（EN） support combined with early nasal liquid feeding and nursing intervention on postoperative nutritional status of patients withesophageal cancer surgery. Methods Ninety-six patientsundergoing esophageal cancer surgery weredivided into experiment group and control group using random number table method, with 48 patients in each group. Patients n experiment group were managed with nasal feeding of EN emulsion, and early nasal liquid feeding and nursing intervention were conducted. Patients m controwith nasogastric feeding of EN suspension and conventionrl care. The nutrition-related indicators （hemoglobin, urea, albumin, prealbumin and toal cholesterol） before operation were compared withthose on the seventh day after operation by PG-SAG scale. Results There was no significant difference in age, gender constitution, time of EN commencement after operation, mean hospitalization days and incidence of perioperative complications between two groups （P 〉 0. 05）. On the seventh day after operation, although the nutrition-related parameters decreased after operation in two groups, theconcentrations of hemoglobin, urea,albumin, prealbumin and total cholesterol in experiment group were significantly higher than those in control group （t= 6.836, P=0.009; t= 6.503, P = 0.012; t=4.492,P=0.028; t=5.073, P=0.020; t=6 .0 8 2 , P= 0. 018） . Conclusions ENcombinedwith nasal liquidfeeding and nursing intervention can improve the perioperative nutritional status and promote postoperative rehabilitation in patients undergoing esophageal cancer surgery.