早期经口进食对食管癌胸腹腔镜手术患者胃肠功能恢复及免疫炎症反应的影响

The effect of early oral feeding on gastrointestinal function recovery and immune inflammatory reaction in patients with esophageal cancer undergoing thoracoscopic and laparoscopic surgery

目的探讨早期经口进食对食管癌胸腹腔镜手术患者胃肠功能恢复及免疫炎症反应的影响。方法选取我院2020年1月至2022年1月收治的82例食管癌胸腹腔镜手术患者,按进食方式不同分为观察组42例(选用早期经口进食)和对照组40例(选用晚期经口进食)。观察两组恢复效果,胃肠功能,炎症反应,营养指标,术后营养不良及并发症情况。结果观察组首次排气、排便、下床活动和住院时间少于对照组(P<0.05);血清胃泌素、胃动素、白蛋白、前白蛋白、转铁蛋白水平高于对照组,血管活性肠肽、超敏C-反应蛋白、白细胞介素-6、肿瘤坏死因子-α低于对照组(P<0.05);观察组术后营养不良发生率低于对照组(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论早期经口进食能够改善患者胃肠功能情况,降低炎症反应,提高营养指标,改善术后营养不良发生情况。

Objective To explore the effects of early oral feeding on gastrointestinal function recovery and immune inflammatory response in patients with esophageal cancer undergoing thoracoscopic and laparoscopic surgery.Methods A total of 82 patients with esophageal cancer undergoing thoracoscopic and laparoscopic surgery in our hospital from January 2020 to January 2022 were selected.According to different feeding methods,they were divided into an observation group(n=42)and a control group(n=40).The observation group was treated with early oral feeding while the control group was treated with late oral feeding.The recovery effect,gastrointestinal function,inflammatory reaction,nutritional index,postoperative malnutrition,and complications were observed.Results The first exhaust,defecation,ambulation and hospitalization time in the observation group were shorter than those in the control group(P<0.05).The serum gastrin(GAS)and motilin(MTL)were higher,and the vasoactive intestinal peptide(VIP)was lower in the observation group than those in the control group(P<0.05).The levels of high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).Albumin(ALB),prealbumin(PAB)and transferrin(TRF)in the observation group were higher than those in the control group(P<0.05).The incidence of postoperative malnutrition in the observation group was less than that in the control group(P<0.05).There was no difference in the incidence of complications between the two groups(P>0.05).Conclusions Early oral feeding can improve the gastrointestinal function,reduce the inflammation,and improve the nutritional indicators and the postoperative malnutrition.