综合干预治疗在食管癌病人术后早期肠内营养耐受性及机体康复的研究

The effect of comprehensive intervention program on early postoperative enteral nutrition tolerance and recovery of patients with esophageal cancer

目的:探讨综合干预方案在食管癌病人术后早期肠内营养(EEN)耐受性及机体康复中的应用效果。方法:将入选的93例病人按入院时间顺序分为综合干预组和传统对照组。综合干预组病人进行综合干预治疗,传统对照组病人给予常规护理,比较两组病人术后EN不耐受的发生率、首次闻及肠鸣音时间、首次排气和排便时间以及并发症等临床指标。结果:综合干预组47例病人中有36例(76.60%)能耐受EEN支持;传统对照组46例病人中有24例(52.17%)耐受EEN支持,两组比较差异有显著性统计学意义(P<0.05)。综合干预组病人首次闻及肠鸣音时间、首次排气和排便时间、住院天数等均优于传统对照组(P<0.01)。且综合干预组病人切口感染、肺部感染发生率均低于传统对照组(P<0.05)。结论:采用综合干预方案治疗食管癌术后病人可有效降低EEN不耐受性的发生率,促进病人机体恢复,缩短住院时间,降低术后并发症,提高病人术后生活质量。

Objective： To explore the effect of comprehensive intervention program based on the concept of fast track surgery in early enteral nutrition tolerance and rehabilitation in patients with esopha- geal cancer. Methods： 93 selected patients were divided into the intervention group and the conven- tional control group according to the admission time. Patients in intervention group were treated with com- prehensive intervention, and control group were given routine nursing care. Enteral nutrition intolerance incidence, the first time of bowel sounds, the first time exhaust and defecation and complications were compared between the two groups. Results： 36 patients from 47 patients （76.60%） in the intervention group could tolerate the early feeding, while 24 patients from 46 patients （52.17%） in the control group could tolerate. There was significant difference between two groups （P 〈 0.05）. The i^rst time of exhaust, bowel sounds and defecation, and the hospitalization time of patients in the intervention group were better than that in the conventional control group （P 〈 0.01 ）. Incidence rate of incision infection, pulmonary infection and in- testinal obstruction in patients of the comprehensive intervention group was lower than that in the control group （P 〈0.05）. Conclusion： Compared with the traditional treatment, the comprehensive intervention can ef- fectively reduce the enteral nutrition intolerance incidence, promote the recovery, reduce hospitalization time and the incidence of postoperative complications ,and improve the life quality of patients after surgery.