食管癌术后肠内营养的时机对胃肠功能恢复的影响

Effects of postoperative enteral nutrition opportunity on the recovery of gastrointestinal function in patients with esophageal cancer

目的探讨食管癌术后肠内营养的时机对胃肠功能恢复的影响。方法行食管癌根治术患者86例,按入院编号分为对照组和观察组,每组43例。单号纳入对照组,术后24~72 h内给予患者肠内营养支持;双号纳入观察组,术后24 h内给予患者肠内营养支持。分析2组干预后营养状况[血清白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TF)]、初次排便时肠道菌群含量、细胞免疫功能(CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+)和胃肠功能恢复情况。结果观察组干预后PA、Alb、TF指标均高于对照组,差异有统计学意义(P<0.05);观察组初次排便时粪便组织中双歧杆菌、乳酸杆菌含量高于对照组,变形杆菌、肠球菌和大肠埃希菌含量低于对照组,差异有统计学意义(P<0.05);观察组干预后CD_3^+、CD_4^+、CD_4^+/CD_8^+水平均高于对照组,CD_8^+水平低于对照组,差异有统计学意义(P<0.05);观察组术后初次排便时间、初次排气时间、肠鸣音恢复时间均短于对照组,差异有统计学意义(P<0.05)。结论食管癌术后24内给予肠内营养支持可提高患者营养状况,改善肠黏膜屏障功能,增强免疫能力,促进胃肠功能恢复,值得推广。

Objective To investigate the effects of postoperative enteral nutrition opportunity on the recovery of gastrointestinal function in patients with esophageal cancer.Methods Eighty-six patients with esophageal cancer who underwent esophageal cancer radical operation in our hospital from February 2015 to February 2017 were enrolled in the study.According to admission number,these patients were divided into two control group(n=43)and observation group(n=43).The patients in control group were given enteral nutritional support during 24~72h after surgery,however,the patients in observation group were given enteral nutritional support within 24 hours after surgery.The nutritional status including Alb,PA and TF,contents of intestinal flora at first defaecation,cellular immune function indexes including CD+3,CD+4,CD+8,CD+4/CD+8 and the recovery state of gastrointestinal function were observed and compared between two groups.Results After intervention the levels of PA,Alb and TF in observation group were significantly higher than those in control group(P<0.05),and the contents of Bifidobacterium and Lactobacillus in fecal tissue in observation group were significantly higher than those in control group,however,the contents of Bacillus proteus,Enterococcus and Escherichia coli in observation group were significantly lower than those in control group(P<0.05).The levels of CD+3,CD+4,CD+4/CD+8 in observation group were significantly higher than those in control group,however,the levels of CD+8 were significantly lower than those in control group(P<0.05).Moreover the first exhaust time,first defecation time,recovery time of bowel sounds in observation group were significantly shorter than those in control group(P<0.05).Conclusion The intestinal nutrition support within 24 hours after esophageal cancer radical operation can improve the nutritional status of patients with esophageal cancer,improve intestinal mucosal barrier function,enhance immuno-competence and promote gastrointestinal function recovery,therefor,which is worth using widely in clinical practice.