家庭肠内营养对食管癌术后并发肌肉减少症的影响

Effect of home enteral nutrition on postoperative sarcopenia in esophageal cancer patients

目的:探讨出院后的家庭肠内营养支持对食管癌患者术后6个月并发肌肉减少症的影响。方法:收集2021年1~12月在南京医科大学附属淮安第一医院行微创食管癌根治术的食管鳞癌患者222例,根据营养支持方式分为家庭肠内营养组(研究组)63例和对照组159例,比较两组患者术后6个月合并肌肉减少症的发生率。结果:两组患者术前L3骨骼肌质量指数(L3 SMI)、血营养指标等差异无统计学意义(P>0.05)。研究组术后6个月肌肉减少症的发生率(9.52%)低于对照组(21.38%)(P<0.05),且术后6个月对照组患者L3 SMI的损失多于研究组(P<0.01);多因素Logistic回归分析提示家庭肠内营养支持、高BMI是食管癌患者术后6个月并发肌肉减少症的重要保护因素(P<0.05),而高龄、术后辅助治疗是并发肌肉减少症的重要危险因素(P<0.05)。结论:出院后延续的家庭肠内营养可以继续强化食管癌患者的营养支持,通过减少患者肌肉丢失,降低肌肉减少症的发生。

Objective:To investigate the effect of enteral nutrition support at home on the incidence of sarcopenia in patients of esophageal cancer in 6 months after operation.Methods:222 patients with esophageal squamous cell carcinoma undergoing minimally invasive radical resection in our hospital were included from January 2021 to December 2021,and divided into home enteral nutrition group(HEN group,n=63)and control group(n=159).The incidence of sarcopenia in half a year after operation was compared between groups.Results:There was no significant difference in preoperative L3 skeletal muscle index(L3 SMI)and blood nutrition index between the two groups(P>0.05).The incidence of sarcopenia in HEN group was significantly lower than that in the control group half a year after operation(9.52%vs.21.38%,P<0.05).The decrease of skeletal muscle index in the control group was significantly greater than that in HEN group during this period(P<0.01).Multivariate logistic regression analysis showed that home enteral nutrition and preoperative higher BMI were important protective factor for postoperative sarcopenia in esophageal cancer patients half a year following surgery(P<0.05),whereas older age and postoperative adjuvant therapy were the risk factors(P<0.05).Conclusion:Home enteral nutrition after discharge can continuously strengthen the nutritional support for esophageal cancer patients and lower the occurrence of sarcopenia by preventing the loss of patients′muscles.