十二指肠营养管在食管癌合并糖尿病患者中的临床应用价值

Clinical Value of Duodenal Nutrient in Patients with Esophageal Cancer and Diabetes

目的探讨十二指肠营养管对食管癌合并糖尿病患者术后肠功能恢复、营养学指标和血糖调控的影响。方法选取我科2019年8月至2021年8月89例食管癌合并糖尿病术后患者作为研究对象,根据随机数字法分为对照组和观察组,其中对照组44例给予肠外营养支持干预,观察组45例采用十二指肠营养管早期肠内营养支持干预,对比两组患者肠功能恢复效果、营养状态指标、血糖调控及术后喉返神经损伤、吻合口瘘、肺炎、切口感染等胃肠道并发症情况。结果干预后,观察组患者肠功能恢复时间、排气排便时间及术后住院时间均小于对照组(P<0.05);干预后,观察组患者前白蛋白、白蛋白、血红蛋白及转铁蛋白水平大于对照组(P<0.05);干预后,观察组患者空腹血糖、餐后2 h血糖及糖化血红蛋白水平、日内平均血糖波动幅度小于对照组(P<0.05);观察组患者喉返神经损伤、吻合口瘘、肺炎、切口感染等胃肠道并发症发生率与对照组相比差异无统计学意义(P>0.05)。结论食管癌合并糖尿病患者术后应用十二指肠营养管,可提高患者术后肠功能水平及营养水平,降低患者血糖指标。

Objective To explore the effect of duodenal nutrient feeding on the recovery of intestinal function,nutritional indicators and blood glucose regulation in postoperative patients with esophageal cancer and diabetes.Methods 89 patients with esophageal cancer complicated with diabetes in our department from August 2019 to August 2021 were selected and divided into 2 groups randomly.44 patients in the control group were given parenteral nutrition support intervention,and 45 patients in the observation group were given early enteral nutrition support intervention with duodenal nutrition feeding.The intestinal function recovery,nutritional status,blood glucose regulation and postoperative gastrointestinal complications such as recurrent laryngeal nerve injury,anastomotic leakage,pneumonia and incision infection were compared between the 2 groups.Results After the intervention,the recovery time of intestinal function,the time of exhaust and defecation and the time of hospitalization in the observation group were shorter than those in the control group(P<0.05);the levels of prealbumin,albumin,hemoglobin and transferrin in the observation group were higher than those in the control group(P<0.05);the fasting blood glucose,blood glucose and glycosylated hemoglobin levels at 2 h after meal and average daily blood glucose in the observation group in the observation group were lower than those in the control group(P<0.05);The incidence of gastrointestinal complications such as recurrent laryngeal nerve injury,anastomotic leakage,pneumonia and incision infection in the observation group was not significantly different from that in the control group(P>0.05).Conclusion The application of duodenal nutrition feeding to the patients with esophageal cancer and diabetes after operation can improve their intestinal function and nutrition level,reduce the blood glucose index of the patients,and ensure the safety of the intervention on this basis.