食管癌两切口术后病人早期行不同途径肠内营养的研究  

The study of early enteral nutrition with different routes after double incisions for the therapy of esophageal cancer

作　　者：徐卫华[1] 钱永跃[1] 

机构地区：[1]苏州大学附属第二医院胸心外科,江苏苏州215004

出　　处：《肠外与肠内营养》2009年第2期87-89,共3页Parenteral & Enteral Nutrition

摘　　要：目的:比较食管癌两切口术后病人早期经鼻肠管和空肠造口管途径行EN支持的方便性、优越性和并发症。方法:选择食管癌两切口手术病人共52例,随机分为三组:A组为鼻肠管组;B组为空肠造口管组;C组为对照组。分别记录术中鼻肠管和空肠造口管的放置时间、观察EN支持期间的临床表现和术后并发症,并测定EN支持前后病人的血糖、肝肾功能、电解质和营养指标等。结果:在研究期间所有病人无死亡,无严重并发症,无明显肝肾功能改变。A组术中放置鼻肠管时间为(22.1±5.9)min;B组术中经空肠穿刺放置Flocare可裂式空肠造口管时间为(8.1±3.7)min,两组差异非常显著(P<0.01)。术后肛门排气恢复的时间A、B组均比对照组快(P<0.01)。PA、TF和外周血TLC均明显升高(P<0.05)。结论:食管癌两切口术后病人早期经鼻肠管和空肠造口管途径行EN支持安全、有效。而经空肠造口管行EN支持,并发症少,是病人术后EEN支持的一条更为合理的途径。tube and cancer. ： Objective： To compare the feasibility, complications and advantages of the nose-intestine the jejunostic tube in early enteral nutrition after double incisions for the therapy of esophageal Methods： 52 postoprative patients were divided into three groups. The nose-intestine tube group （A group, n = 16） and the jejunostic tube group （B group, n = 21） received the enteral nutrition（ Nutrison Fibre） and the conrtrol group （C group, n = 15 ） received intravenous isotonic glucose solution and oral liquid diet after the bowel movement recovery. The blood glucose, the function of liver and kidney, electrolytes and nutritional status were observed. The recovery of bowel movement and other digestive symptoms such as abdominal pain, distention, diarrhea, nausea and vomiting were observed during the period of study. Some complications such as acute intestinal obstruction, pnumonia and rhinolaryngitis were observed during the period of study. Results： The time for placing the jejunostic tube was faster than that for placing the nose-intestine tube （P 〈 0.01 ）. The recovery of bowel movement in both A and B group was much earlier than that in C group. When compared with C group, prealbumin,transferrin and the lymphocyte count in A or B group were increased significantly （P 〈 0.05 ） . No other significant changes were noted in three groups. Conclusion ： Both the nose-intestine tube and the jeju- nostic tube for early enteral nutrition is safe and effective after double incisions for the therapy of esophageal cancer. The jejunostic tube for early enteral nutrition is better than the nose-intestine tube in shortenning the placing time and the complications of pneumonia and rhinolaryngitis.

关 键 词：早期肠内营养 食管癌手术 鼻肠管 空肠造口管 

分 类 号：R735.1[医药卫生—肿瘤] R459.3[医药卫生—临床医学]