食管癌术后早期经口进食对患者早期预后的影响

Impact of early oral feeding on early prognosis after esophageal operation

目的探讨食管癌术后早期经口进食(EOF)对患者早期预后的影响。方法回顾性分析该院2016年1月至2018年2月进行食管癌根治术治疗的179例食管癌患者的临床病理资料,根据术后进食方法将87例术后未安置胃管或24 h内拔出胃管、48 h内经口进食的患者作为EOF组;92例术后经营养管管喂营养液的患者作为对照组,比较两组患者术后实验室指标、恢复情况、并发症情况和住院费用。结果两组患者术后第1、3、7天血红蛋白、清蛋白、前清蛋白水平比较,差异均无统计学意义(P>0.05);两组患者在术后排气排便时间、ICU停留时间、住院时间和住院费用方面比较,差异均有统计学意义(P<0.01)。对照组患者术后吻合口瘘和重症肺炎发生率虽高于EOF组,但经Kaplan-Meier曲线分析比较两组患者术后吻合口瘘和重症肺炎发生率差异无统计学意义(9.78%vs.6.90%和20.65%vs.16.09%,P>0.05);Cox多因素分析显示EOF不影响吻合口瘘的发生(HR=3.633,95%CI:0.272~48.553,P=0.329)。结论食管癌术后EOF不增加早期吻合口瘘的发生,并可明显缩短住院时间、减少住院费用。

Objective To investigate the impact of early oral feeding(EOF)on early prognosis after esophageal cancer operation.Methods The clinicopathological data of 179 patients with esophageal cancer radical operation in this hospital from January 2016 to February 2018 were retrospectively analyzed.Among them,87 cases of non-nasogastric tube or pulling out nasogastric tube within 24 h and accepting oral feeding within 24 h served as the EOF group,and 92 cases of feeding nutrition fluid by nutritional tube served as the control group.The laboratory indicators,recovery situation,complications and hospitalization expenses were compared between the two groups.Results There were no statistically significant differences in the levels of hemoglobin,albumin,prealbumin on postoperative 1,3,7 d between the two groups(P>0.05).The aspects of postoperative exhausting time,ICU stay duration,hospitalization time and expenses had statistical differences between the two groups(P<0.01).Although the incidence rates of postoperative anastomotic leakage and severe pneumonia in the control group were higher than those in the EOF group,but which had no statistical significance by Kaplan-Meier curve analysis(9.78%vs.6.90%,20.65%vs.16.09%,P>0.05);the Cox multivariate analysis showed that EOF did not affect the occurrence of anastomotic leakage(HR=3.633,95%CI:0.272-48.553,P=0.329).Conclusion EOF after esophageal cancer operation does not increase the occurrence of early anastomotic leakage,can obviously shorten the hospitalization duration and reduce the hospitalization expenses.