微生态制剂联合肠内营养对食管癌患者术后肠功能及营养状况的影响

The effects of microecological preparations combined with enteral nutrition on postoperative intestinal function and nutritional status in patients with esophageal cancer

目的探讨微生态制剂联合肠内营养对食管癌患者术后肠功能及营养状况的影响。方法选取2018年6月至2018年12月我院胸外科食管癌术后患者58例,随机分为观察组(n=27)和对照组(n=31)。对照组患者术后采用常规肠内肠外联合营养支持方案,观察组患者在对照组基础上给予微生态制剂(活菌型乳酸菌乳饮品)鼻饲。比较两组患者腹胀、腹泻的发生率,通气时间,首次排便时间,留置胃管时间,住院时间,住院总费用,血红蛋白、前白蛋白、转铁蛋白、白蛋白、视黄醇结合蛋白水平及出院时BMI值的变化。结果观察组患者术后发生腹胀和腹泻的比率明显低于对照组,通气时间、首次排便时间均早于对照组(P<0.05)。观察组患者首次饮水时间提前,胃管置留天数及术后住院天数也较对照组缩短(P<0.05)。两组患者出院时BMI值比较差异具有统计学意义(P<0.05)。结论微生态制剂(活菌型乳酸菌乳饮品)联合肠内营养能改善食管癌患者术后的肠功能,降低肠内营养不耐受的发生率,有利于肠内营养的实施,促进患者康复。

Objective To explore the effects of microecological preparations combined with enteral nutrition on postoperative intestinal function and nutritional status in patients with esophageal cancer. Methods Fifty-eight postoperative patients with esophageal cancer in our department from June 2018 to December 2018 were selected and randomly divided into observation group(n=27) or control group(n=31). Both groups were treated with conventional enteral and parenteral nutrition support program. The observation group was additionally given microecological preparations(viable lactic acid bacteria milk drink)via nasal feeding. The incidences of abdominal distension and diarrhea, ventilation time, first defecation time, gastric tube retention time, length of hospital stay and total hospitalization expenses, as well as the serum levels of preprotein, transferrin, albumin and retinol binding protein and BMI value at discharge were compared between groups. Results The incidence rates of postoperative abdominal distension and diarrhea in the observation group were significantly lower than those in the control group. The ventilation time and first defecation time in the observation group were earlier than those in the control group(P<0.05). The time of first drinking of the patients in the observation group was earlier, and the days of gastric tube retention and postoperative hospital stay were less than in the control group(P<0.05). There was a significant difference in BMI value at discharge between the two groups(P<0.05). Conclusion Microecological preparations(viable lactic acid bacteria milk drink) combined with enteral nutrition can improve the intestinal function of postoperative patients with esophageal cancer and reduce the incidence of enteral nutrition intolerance, which is conducive to the implementation of enteral nutrition and the rehabilitation of patients.