食管癌术后早期肠内营养与肠外营养效果比较

To compare clinical effect of early enteral nutrition and parenteral nutrition on esophageal cancer after operation

目的比较早期肠内外营养应用于食管癌术后预防肺部感染的临床效果。方法选取行食管癌根治手术的150例患者,根据患者意愿分为肠外营养组(PN)和肠内营养组(EN),每组75例。分别术后给予全胃肠外营养和经鼻肠管滴注肠内营养支持。比较2组患者术后并发症(静脉炎、腹泻、肺部感染、吻合口瘘)、手术前后血清白蛋白、血红蛋白、内毒素、淋巴细胞数、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平等。结果术后EN组并发症发生率低于PN组(P<0.05),差异有统计学意义。2组术前与术后7 d相比较,血清白蛋白、血红蛋白、内毒素、淋巴细胞、ATL及AST水平均显著改善,但EN组改善效果显著优于PN组(P<0.05),且肠道恢复时间及营养费用等均显著低于PN组(P<0.05),差异均有统计学意义。结论食管癌术后早期肠内营能够有效预防肺部感染等并发症发生率,促进患者术后早日康复。

Objective To study the esophageal cancer early postoperative enteral nutrition on preventing pulmonary infection.Methods In our hospital underwent esophageal cancer resection 150 patients,according to the wishes of patients divided into parenteral nutrition group（ PN） and enteral nutrition（ EN） group,75 cases in each group respectively,after intravenous parenteral nutrition（ PN） and nasal tube infusion of enteral nutrition（ EN） support,compared two groups postoperative complications（ phlebitis,diarrhea,pulmonary infection,anastomotic fistula）,serum albumin,hemoglobin before and after surgery,internal toxin,lymphocyte count,alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST） levels. Results Postoperative enteral nutrition group and lower complication rate than the parenteral nutrition group（ P〈0. 05）; Preoperative and postoperative 7 days compared with serum albumin,blood red protein. Endotoxin,lymphocyte,ATL and AST levels were significantly improved,and enteral nutrition group were significantly better than the parenteral nutrition group（ P〈0. 05）,and group EN recovery time and economic costs were significantly lower than PN group. Conclusion Early postoperative intestinal tract can effectively prevent lung infection and other complications,Which is beneficial to the early recovery of patients.