经鼻肠内营养对食管癌患者术后并发症、免疫功能及康复进程的影响

Effect of Nasal Enteral Nutrition on Postoperative Complications, Immune Function and Rehabilitation Process in Patients with Esophageal Carcinoma

目的研究经鼻肠内营养对食管癌患者术后并发症、免疫功能及康复进程的影响。方法依据不同营养方式将该院2016年2月-2018年2月收治的90例食管癌患者分为观察组(50例)与对照组(40例)。观察组术后接受经鼻肠内营养支持,对照组术后则行肠外营养支持。统计比较各组相关资料。结果首次排气时间、排便时间、创口愈合时间及住院时间方面,观察组均显著短于对照组(P<0.05);观察组吻合口瘘、切口感染、肺部感染发生率分别为3例(6.00%)、2例(4.00%)、2例(4.00%),较对照组的5例(12.50%)(χ^2=1.159,P=0.282)、5例(12.50%)(χ^2=2.238,P=0.135)、6例(15.00%)(χ^2=3.320,P=0.068),差异无统计学意义(P>0.05);与术后第1天比较,观察组术后第8天血清白蛋白(ALB)、前白蛋白(PA)、血清总蛋白(TP)、CD3^+、CD4^+、CD4^+/CD8^+、IgA、IgM、IgG(35.00±4.55)g/L、(152.17±18.23)mg/L、(62.79±7.41)g/L、(46.07±4.38)%、(35.84±3.59)%、(1.65±0.20)、(2.48±0.34)g/L、(1.53±0.18)g/L、(13.62±1.63)g/L均显著上升,CD8^+(21.69±2.15)%显著下降,差异有统计学意义(P<0.05);观察组术后第8天ALB、PA、TP、CD3^+、CD4^+、CD4^+/CD8^+、IgA、IgM、IgG均显著高于、CD8+显著低于对照组(P<0.05)。结论经鼻肠内营养支持能明显缩短食管癌患者术后肠道功能恢复时间,加快切口愈合进程,可有效减少术后并发症,显著改善患者免疫功能。

Objective To study the effects of transnasal enteral nutrition on postoperative complications, immune function and rehabilitation process in patients with esophageal cancer. Methods Ninety patients From February 2016 to February 2018 with esophageal cancer were divided into observation group (50 cases) and control group (40 cases) according to different nutrition methods. The observation group received postoperative enteral nutrition support, and the control group received parenteral nutrition support. Statistical comparison of relevant data of each group. Results The first exhaust time, defecation time, wound healing time and hospitalization time were significantly shorter in the observation group than in the control group (P<0.05). The incidence of anastomotic leakage, wound infection and lung infection in the observation group were 3 cases ( 6.00%), 2 cases (4.00%), 2 cases (4.00%), 5 cases (12.50%) compared with the control group (χ^2=1.159, P=0.282), 5 cases (12.50%)(χ^2=2.238, P =0.135), 6 cases (15.00%)(χ^2=3.320, P=0.068), the difference was not statistically significant (P>0.05);compared with the first day after surgery, the 8th day after surgery, serum albumin (ALB)), prealbumin (PA), serum total protein (TP), CD3^+, CD4^+, CD4^+/CD8^+, IgA, IgM, IgG (35.00±4.55) g/L,(152.17±18.23) mg/L,(62.79± 7.41) g/L,(46.07±4.38)%,(35.84±3.59)%,(1.65±0.20),(2.48±0.34) g/L,(1.53±0.18) g/L,(13.62±1.63) g /L was significantly increased, CD8^+(21.69±2.15)% decreased significantly, the difference was statistically significant (P<0.05);the observation group was 8 th days after operation, ALB, PA, TP, CD3^+, CD4^+, CD4^+/CD8^+, IgA, IgM IgG was significantly higher than CD8^+ the control group (P<0.05). Conclusion Naso-intestinal nutrition support can significantly shorten the recovery time of postoperative intestinal function in patients with esophageal cancer and accelerate the healing process of incision, which can effectively reduce postoperative complications and significantly improve the immune function of patients.