结直肠癌腹腔镜手术病人围手术期肠内营养的临床研究  

Clinical study on perioperative enteral nutritional support in patients with colorectal cancer treated by laparoscopic surgery

作　　者：陈国栋[1] 贺更生[1] 黄秋林[1] 罗加兴[1] 张伟[1] 廖黎[1] 

机构地区：[1]南华大学附属第一医院普通外科,421001

出　　处：《大家健康（学术版）》2012年第24期2-5,共4页

摘　　要：目的探讨结直肠癌腹腔镜手术病人围手术期肠内营养支持的可行性、有效性及必要性。方法将73例拟行腹腔镜下结直肠癌切除术病人随机分为肠内营养组(实验组,n=37)及肠外营养组(对照组,n=36)。比较两组病人术前第3d及术后第7d体重(WT)、血红蛋白(HB)、白蛋白(ALB)、总蛋白(TB)及总淋巴细胞计数(TLC)变化;记录术中肠道清洁程度、术后肛门或造口排气排便时间及住院天数;观察消化道不良反应及统计并发症的发生例数。结果对照组内各项营养指标术后7d较术前3d均明显降低(P<0.05),而实验组内只有TLC降低明显(P<0.05),ALB及TLC在实验组手术前后的降幅较对照组明显减少(P<0.05);实验组肛门或造口排气时间比对照组明显提前(P<0.05),对照组术后不良反应总体发生率显著高于实验组(44.4%比21.6%,P<0.05);两组肠道清洁度和并发症无显著性差异。结论围手术期肠内营养支持可改善腹腔镜下结直肠癌切除病人的预后。Objective To study the clinical safety,result and feasibility from enteral nutritional support in patients with colorectal cancer treated by laparoscopic surgery.Methods 73 cases of colorectal cancer patients treated by laparoscopic surgery were prospectively randomized to enteral nutrition group (experimental group,n=37) and parenteral nutrition (control group,n=36).The body weight (WT),hemoglobin (HB),albumin (ALB),total protein (TB) and total lymphocyte count (TLC) were measured on preoperative and the 7th postoperation day (POD) respectively.The colon cleanliness,the times of anal exhaust and defecation time after surgery,the postoperative hospital stay,the gastrointestinal adverse reactions and complications after surgery of each group were compared.Results The nutrition indicators of POD7 were significantly lower than that of POD3 in the control group (P<0.05),but were not significant in the experimental group except for TLC;the decline of ALB and TLC was significantly reduced in the experimental group (P<0.05).There was significant difference in gastrointestinal function and incidence of postoperative complications (P<0.05).But there was no significant difference in colon cleanliness and complication between the two groups.Conclusion Perioperative enteral nutrition can improve the prognosis of colorectal cancer patients treated by laparoscopic surgery abdominal surgery patients.

关 键 词：肠内营养 结直肠癌 围手术期 并发症 预后 

分 类 号：R735.3[医药卫生—肿瘤]