腹腔镜结直肠癌根治术后口服肠内营养对术后康复作用的临床研究

Effect of oral enteral nutrition on postoperative recovery after laparoscopic colorectal cancer resection:a clinical study

目的:探讨术后早期口服肠内营养(enteral nutrition,EN)对腹腔镜结直肠癌术后患者康复作用的影响。方法:前瞻性分析2021年5月至2022年2月本院拟行腹腔镜结肠癌根治术100例患者的临床资料,采用随机数字表法将患者分为观察组(EN)及对照组(非EN)各50例。观察组从术后第1天给予口服肠内营养,并调整浓度及剂量,逐渐增加至全量;对照组给予口服等量的温开水,待通气后给予流质饮食,并逐步过渡至正常饮食。测定两组患者术后第7天营养、炎症及肠屏障功能等指标,记录两组患者术后排气、排便、下床时间及术后住院时间。结果:本研究100例结直肠癌患者均治愈出院,观察组患者恢复正常饮食时间(t=4.658;P<0.05)和术后住院日(t=6.304;P<0.05)均显著短于对照组;术后第7天,两组患者在血红蛋白及白蛋白等营养指标水平未见显著差异(P>0.05),但观察组外周血白细胞计数(t=4.973;P<0.05)、C反应蛋白(t=5.075;P<0.05)、中性粒细胞计数(t=7.597;P<0.05)水平均显著低于对照组;观察组患者二胺氧化酶(t=18.457;P<0.05)和粪便钙卫蛋白(t=9.142;P<0.05)水平均显著低于对照组,闭锁小带蛋白-1(t=18.141;P<0.05)显著高于对照组。结论:腹腔镜结直肠癌根治术后早期口服肠内营养可促进术后胃肠道功能恢复,提高术后康复效果。

Objective:To investigate the effect of early oral enteral nutrition(EN)on the recovery of patients after laparoscopic colorectal cancer surgery.Methods:Patients who were scheduled for laparoscopic radical colorectal cancer surgery in our hospital from May 2021 to February 2022 were prospectively enrolled and randomly divided into the observation(EN)group and the control(non-EN)group.The observation group was given oral enteral nutrition from the first day after surgery,and the concentration and dose were adjusted over time to full dose.The control group was given equal volume of hot water for drinking,then the liquid diet was given after ventilation,and gradually transitioned to normal diet.The indicators of nutrition,inflammation,and intestinal barrier function were measured on the 7th day after surgery.The postoperative exhaust time,bowel movement,off-bed time,and hospital stay of the two groups were recorded.Results:A total of 100 patients were cured and discharged.Time to return to normal diet(t=4.658;P<0.05)and postoperative hospital days(t=6.304;P<0.05)of the observation group were significantly shorter than those in the control group.On 7th day after surgery,no significant differences were observed in nutritional indicators such as levels of hemoglobin and albumin between the two groups(P>0.05),but the levels of peripheral white blood cell count(t=4.973;P<0.05),C-reactive protein(t=5.075;P<0.05),and neutrophil count(t=7.597;P<0.05)in the observation group were significantly lower than those in the control group.The levels of diamine oxidase(t=18.457;P<0.05)and fecal calprotectin(t=9.142;P<0.05)of the observation group were significantly lower than those in the control group.The levels of zonula occludens-1 of the observation group were significantly higher in than control group(t=18.141;P<0.05).Conclusion:Early oral enteral nutrition after laparoscopic radical colorectal cancer surgery can promote postoperative gastrointestinal function recovery and improve postoperative recovery.