早期肠内营养护理在食管癌围手术期快速康复治疗中的应用

A Study on the Application of Early Enteral Nutrition to Improve Patients′Life Quality in the Rapid Rehabilitation Therapy for Esophageal Cancer During the Perioperative Period

目的探讨早期肠内营养(EEN)护理措施应用于食管癌围手术期快速康复治疗中对提高患者生活质量的应用情况。方法纳入遂宁市中心医院2013年1月至2014年12月食管癌患者64例作为研究对象,随机分为对照组和观察组各32例。对照组采用肠外营养(total parenteral nutrition,TPN)护理,观察组采用EEN护理,比较两组患者血清白蛋白水平、肠道功能恢复时间、肛门排气时间、拔管时间、住院时间、住院费用和生活质量。结果对照组和观察组术前和术后1d血清白蛋白差异无统计学意义(P>0.05);术后3d和术后5d对照组血清白蛋白均低于观察组,差异有统计学意义(P<0.05);对照组术后肠鸣音恢复时间、肛门排气时间和拔管时间均长于观察组,差异有统计学意义(P<0.05);对照组住院时间长于观察组,住院费用高于观察组,差异有统计学意义(P<0.05);对照组和观察组术前生活质量各项目差异无统计学意义(P>0.05),术后1周对照组总身体状况评分、认知功能分数较观察组低,差异有统计学意义(P<0.05);疲劳乏力、失眠、食欲下降、便秘、腹泻和经济困难分数较观察组高,差异有统计学意义(P<0.05)。结论 EEN护理在快速康复外科理念指导下的食管癌围手术期对提高患者生活质量具有明显作用,能够改善患者实验指标,缩短住院时间和住院费用,值得临床推广实施。

Objective To explore the application of early enteral nutrition （EEN） to improve patients＇ life quality in the rapid rehabilitation therapy for esophageal cancer during the perioperative period. Methods 64 patients of esophageal cancer, who were treated from January of 2013 to December of 2014 in Suning Central Hospital, were selected as research objects and randomly divided into the control group and the observation group, and each group consisted of 32 cases. The control group was given the nursing of total parenteral nutrition （TPN）, while the observation group was treated with the nursing of EEN. The comparisons were made between the two groups in levels of serum albumin, recovery time of intestinal function, flatus time, extubation time, length of hospital stay, hospitalization expenses and life quality. Results The levels of serum albumin in the observation group were not significantly different from those in the control group before the surgery and one day after the surgery respectively （P〉0.05）, but they were significantly lower than those in the control group 3 days and 5 days after the surgery respectively （P〈0.05）. The time of the bowel sound recovery, flatus and extubation was significantly longer in the control group than in the observation （P〈0.05） ; there were longer hospital stay and higher hospitalization cost in there control group than in the observation group and the differences were statistically significant （P〈0.05）, but there were no significant differences in the life quality between the two groups （P〉 0.05）. The scores of the total body status and the cognitive function were lower and the scores of fatigue, insomnia, anorexia, constipation, diarrhea and economic difficulty were higher in the control group than in the observation group, and the differences were statistically significant （P〈0.05）. Conclusion The EEN nursing has a positive effect on the improvement of patients, life quality in the rapid rehabilitation therapy for esophageal cancer during the perioperative period, and it can also improve the experimental index, shorten the length of hospital stay and reduce the hospitalization cost. Therefore, it is worth the clinical application.