结直肠癌病人腹腔镜术后早期肠内营养的临床研究  

Clinical study on postoperative early enteral nutrition support in patients with colorectal cancer treated by laparoscopic surgery

作　　者：葛智成[1] 王宇[1] 张忠涛[1] 王康里[1] 金岚[1] 王今[1] 张军[1] 王琦[1] 

机构地区：[1]首都医科大学附属北京友谊医院普通外科,北京100052

出　　处：《肠外与肠内营养》2007年第5期290-292,共3页Parenteral & Enteral Nutrition

摘　　要：目的:探讨结直肠癌腹腔镜手术和剖腹手术术后早期肠内营养(EEN)支持的效果和肠功能的恢复情况,并观察其安全性。方法:将32例结直肠癌病人随机分为两组,即剖腹组行剖腹手术;腹腔镜组行腹腔镜手术,每组16例。所有病人于术后第1天起给予同样肠内营养,并逐量增加,共6 d,前4 d同时给予肠外营养。观察肝肾功能、血脂、前清蛋白(PA)、肠功能恢复时间、消化道症状和各种相关并发症的发生情况等。结果:腹腔镜组较剖腹组术后肠功能恢复时间显著提前(P=0.002)。两组高密度脂蛋白、低密度脂蛋白、胆固醇和谷丙转氨酶经营养支持后与术前比均有显著性差异(P<0.05)。剖腹组肌酐、尿素氮术前和营养支持后比有显著性差异(P=0.002,P=0.012)。剖腹组清蛋白营养支持后显著低于术前(P=0.001),两组营养支持后清蛋白和总蛋白剖腹组显著低于腹腔镜组(P=0.004,P=0.031)。结论:结直肠癌病人术后EEN支持,有利于营养状况恢复,是安全、合理的营养支持途径。在EEN治疗下腹腔镜组在营养状况和肠功能恢复上较剖腹组有明显优势。Objective： To evaluate the effect,safety and the resumption of gastrointestinal function of postoperative early enteral nutrition（EEN） support after laparoscopic surgery and open surgery in patients with colorectal cancer.Methods： 32 cases with colorectal cancer were randomly divided into two groups.16 cases treated by laparoscopic surgery were in laparoscopic group,and other 16 cases treated by open surgery were in open group.All cases were given enteral nutrition from the first post-operative day to the sixth day.The biochemical indicator,blood-Lipids,prealbumin（PA）,the time of resumption of gastrointestinal function and gastrointestinal reaction were observed.Results： The time of resumption of gastrointestinal function in laparoscopic group was significantly earlier than that in the open group（P=0.002）.The serum albumin level after nutrition support was significantly lower（P=0.001） than before the operation in open group.The albumin and total protein in laparoscopic group were significantly lower（P=0.004,P=0.031） than those in open group.Conclution： EEN is a safe and effective nutritional pathway after operation of colorectal cancer.The resumption of gstrointestinal function in laparoscopic group is obviously better than that in open group.

关 键 词：肠内营养 肠外营养 腹腔镜 结直肠癌 

分 类 号：R735.3[医药卫生—肿瘤] R459.3[医药卫生—临床医学]