早期肠内营养在结肠癌术后加速康复外科中的应用研究

Application of Early Enteral Nutrition Guided by Enhanced Recovery After Surgery in Patients with Colon Cancer

目的探讨加速康复外科理念指引下的早期肠内营养对结肠癌术后肠道功能恢复及预后的影响。方法选取江苏省泰州市人民医院确诊为结肠癌并实施结肠癌根治术的患者64例,随机分为试验组(早期肠内营养组)和对照组(全肠外营养组),每组32例,试验组给予肠内营养支持,对照组给予肠外营养支持。观察两组患者免疫状况、营养状况、首次肠道排气排便的时间、恢复经口饮食的时间、住院时间及治疗费用,以及患者6个月无进展生存比率。结果术后第7天,实验组患者免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、前白蛋白水平高于对照组,两组患者首次肛门排气时间、排便时间、恢复经口饮食时间比较差异均有统计学意义(P<0.05)。结论加速康复外科理念指引下的早期肠内营养支持治疗可快速恢复结肠癌术后患者肠道功能,改善营养状况,增强免疫功能,缩短住院时间,降低治疗费用,但未能显著提高结肠癌患者6个月无进展生存的比率。

Objective To explore the effect of early enteral nutrition guided by enhanced recovery after surgery in patients with colon cancer.Methods The patients who were admitted to our hospital diagnosed as colon cancer and underwent radical resection of colon cancer were randomly divided into experimental group(early enteral nutrition group)and control group(total parenteral nutrition group),which included 32 cases respectively.The patients in experimental group were treated with early enteral nutrition support,while the patients in control group were treated with total parenteral nutrition.The immune and nutritional status,the time of the first bowel exhaust defecation and first oral diet,hospital length of stay(LOS),and the cost of treatment were observed.Results At the 7th day after operation,there were significant difference between the two groups in IgA,IgG,IgM and pre-albumin.There were also significant difference in time of the first bowel exhaust defecation and first oral diet,hospital LOS,and the cost of treatment.Conclusion Early enteral nutrition support guided by enhanced recovery after surgery could quickly restore intestinal function,improve nutritional and immune status,shorten the hospital LOS,and reduce the cost of treatment.