早期肠内营养支持在高龄食管癌患者术后应用的临床研究

Clinical studies on early postoperative enteral nutrition in patients aged 70 and older following esophageal cancer surgery

目的评价高龄食管癌患者术后早期肠内营养的应用效果。方法选取57例高龄食管癌切除患者,术后早期行肠内营养支持39例(EN组),行肠外营养支持18例(PN组),进行对比分析。结果肛门排气时间,EN组(56.3±4.2)小时,PN组(68.4±6.1)小时(t=-8.8,P<0.05),明显缩短;血清蛋白指标(白蛋白、前白蛋白、转铁蛋白)治疗前两组无明显差异,治疗后,EN组白蛋白(33.5±2.3)g/L,前蛋白(223±18)mg/L,转铁蛋白(2.9±0.4)g/L,分别高于PN组(30.5±1.9)g/L(t=4.5,P<0.05),(207±12)mg/L(t=3.5,P<0.05),(2.1±0.2)g/L(t=9.7,P<0.05);术后感染性并发症发生率,EN组10.2%,明显低于PN组33.3%(字2=4.9,P<0.05);心血管性并发症发生率,EN组12.8%,明显低于PN组发生率38.9%(字2=5.0,P<0.05)。结论高龄食管癌患者术后早期肠内营养支持比肠外营养支持更有优越性。

Objective To determine the effects of clinical studies on early postoperative enteral nutrition in patients aged 70 and older following esophageal cancer surgery. Methods Fifty and seven patients with esophageal carcinoma were divided into the enteral nutrition (EN) group (n=39) and the parenteral nutrition (PN) group (n=18). All patients in the 1st and 10th days after operation were measured the level of serum albumin (Alb), the former albumin (PA) and transferrin (TF). The resumption of gastrointestinal function,as well as complications after operation were observed.Results The time of resumption of gastrointestinal function in EN group(56.3± 4.2) h was significantly earlier than that in group PN (68.4±6.1) h (t=-8.8, P<0.05). There were no differences in Alb, PA, TF before treatment between the two groups. The Alb of group EN was significantly higher than that in group PN (33.5±2.3 g/L vs 30.5±1.9 g/L, t=4.5, P<0.05), PA of group EN was significantly higher than that in group PN (223±18 mg/L vs 207±12 mg/L, t=3.5, P<0.05), TF of group EN was significantly higher than in group PN (2.9±0.4 g/L vs 2.1±0.2 g/L, t=3.5, P<0.05). Incidence of infectious complications in group EN (10.2%) was lower than that in group PN (33.3%) ( X2=4.9,P<0.05) after the treatment. Incidence of cardiovascular complica-tions in group EN (12.8%) was lower than in group PN (38.9%) ( X2=5.0,P<0.05). Conclusions Early en-teral nutrition can significantly improve the nutritional status, as well as promotion of gastrointestinal function of elderly patients with esophageal cancinoma after operation, and reduce the incidence of complications.