腹腔镜直肠癌根治术(Dixon)术后接受早期肠内营养的临床疗效分析

Clinical Analysis of Early Enteral Nutrition after Laparoscopic Radical Resection of Rectal Cancer(Dixon)

目的在接受腹腔镜直肠癌根治术(Dixon)的患者术后早期通过鼻空肠营养管给予肠内营养,分析其术后临床疗效。方法从2017年1月—2020年5月在赣榆区人民医院普外科接受腹腔镜直肠癌根治术(Dixon术)的患者中选取80例患者作为研究对象。按照直肠癌术后营养供给方式不同分成研究组和对照组。研究组40例患者直肠癌术后早期通过鼻空肠营养管给予肠内营养治疗,对照组40例患者术后给予完全胃肠外营养。分析比较研究组和对照组患者术前、术后7 d监测营养指标、炎症指标之间差异,比较研究组和对照组直肠癌术后并发症发生率、术后肛门首次通气时间、住院费用、住院天数的差异。结果研究组与对照组对比,在术后第7天研究组营养指标(TP、ALB、PAB)明显高于对照组,差异有统计学意义(P<0.05);研究组炎症指标(WBC、NE%)明显低于对照组,差异有统计学意义(P<0.05);研究组在术后肛门首次排气时间(54.6±3.0)h、住院费用(40450±5424)元及住院天数(14.7±3.9)d明显优于对照组(69.9±3.6)h、(45470±4888)元、(17.0±3.9)d,差异有统计学意义(t=20.734、4.348、2.637,P<0.05),研究组术后并发症发生率10%明显少于观察组30%,差异有统计学意义(χ^2=5.000,P=0.025)。结论腹腔镜直肠癌根治术后通过鼻空肠营养管早期给予肠内营养支持能明显增加患者的营养指标,降低感染指标,缩短肛门首次排气时间,降低术后并发症发生率,缩短住院天数,减少住院费用。

Objective To analyze the clinical efficacy of patients receiving laparoscopic radical resection of rectal cancer(Dixon)with enteral nutrition through a nasojejunal nutrition tube in the early postoperative period.Methods From January 2017 to May 2020,80 patients who underwent laparoscopic radical resection of rectal cancer(Dixon)at the General Surgery Department of Ganyu District People's Hospital were selected as the research objects.According to the different ways of nutrition supply after rectal cancer surgery,they were divided into study group and control group.Forty patients in the study group were given enteral nutrition through a nasojejunal nutrition tube early after surgery,and 40 patients in the control group were given complete parenteral nutrition after surgery.Analyze and compare the differences between the preoperative and 7 days postoperative monitoring nutritional indicators and inflammation indicators between the study group and the control group.Compare the study group and the control group with the incidence of postoperative complications of rectal cancer,the first postoperative anal ventilation time,and the hospitalization cost,the difference in length of hospital stay.Results The study group was compared with the control group.The nutritional indicators(TP,ALB,PAB)of the study group were significantly higher than those of the control group on the 7th day after surgery,and the difference was statistically significant(P<0.05);Inflammation indicators(WBC,NE%)were significantly lower than those of the control group,and the difference was statistically significant(P<0.05);in the study group,the first postoperative anal exhaust time was(54.6±3.0)h,and the hospitalization cost(40450±5424)yuan and the number of hospitalization days(14.7±3.9)d were significantly better than the control group(69.9±3.6)h,(45470±4888)yuan,(17.0±3.9)d,the difference was statistically significant(t=20.734,4.348,2.637 P<0.05),the postoperative complication rate of 10% in the study group was significantly less than 30% in the observation group,and the difference was statistically significant(χ^2=5.000,P=0.025).Conclusion Early enteral nutrition support through nasojejunal nutrition tube after laparoscopic radical resection of rectal cancer can significantly increase the patient’s nutritional indicators,reduce infection indicators,shorten the time of first air exhaust from the anus,reduce the incidence of postoperative complications,and shorten the length of hospital stay,reduce hospitalization costs.