肠内营养制剂在结、直肠癌术前肠道准备中的应用研究  

Application of Enteral Nutrition in Preoperative Bowel Preparation for Patients with Colorectal Carcinoma

作　　者：邓姣[1] 杨静[1] 杨荣[1] 

机构地区：[1]中南大学湘雅医院胃肠外科,湖南长沙410008

出　　处：《现代生物医学进展》2010年第18期3497-3501,共5页Progress in Modern Biomedicine

摘　　要：目的:探讨结、直肠癌患者术前使用肠内营养制剂行肠道准备替代传统肠道准备方法的可行性。方法:结、直肠癌患者42例,随机分为实验组和对照组,实验组(肠内营养组,即EN组)21例,给予口服瑞素,口服肠道消炎药,静脉补液行术前肠道准备。对照组(硫酸镁组)21例,术前禁食、静脉补液,口服硫酸镁及肠道消炎药行术前肠道准备。然后分别于肠道准备前(术前第五日晨)及手术当日晨和术后第三日进行各项营养评定,比较两组的肠道清洁度,不良反应及术后并发症。结果:两组病人肠道清洁度均较好,无显著性差异(P>0.05)。实验组肠道准备期间大便次数明显少于对照组(P<0.01)。实验组病人不良反应发生率低于对照组,差异具有显著性(P<0.05)。实验组术后感染、吻合口漏发生率均低于对照组,但差异无显著性(P>0.05)。实验组患者术后肠道功能恢复时间早于对照组(P<0.01)。实验组的多项营养评定指标在肠道准备前、后明显优于对照组(P<0.05)。实验组术后的多项实验室指标均优于对照组,差异具有显著性(P<0.01)。结论:结、直肠癌患者以肠内营养制剂(瑞素)行术前肠道准备能保证良好肠道清洁度,有效改善患者术后的营养状况,减少不良反应发生,效果优于传统方法,值得在临床推广。Objective：To investigate the application of enteral nutrition in preoperative bowel preparation for Patients with col-orectal carcinoma.Methods：42 patients with colorectal carcinoma were randomized into study group and control group.21 patients in the study group（EN group）were applied with Fresubin and intestinal anti-inflammatory drug,and intravenous resuscitation in preoperative bowel preparation.21 patients in the control group（traditional therapy group）were given traditional liquid diet for bowel preparation.They were fasted and applied with Magnesium Sulfate and intestinal anti-inflammatory drug and intravenous resuscitation before opera-tion.The changes of nutritional parameters,satisfactory of colon cleaning,occurrence of adverse effect and complication were observed.Results：The satisfactory of colon-cleaning were good in two groups,and there were no significant difference in both groups（P0.05）.The times of stool frequency in the EN group were significantly fewer than those in the control group（P0.01）.The incidence of adverse reactions was significantly lower in study group than that in control group（P0.05）.Post-operative of rate of infection and anasto-motic leakage were lower than the control group,but the differences were not significant（p0.05）.The intestinal function recovery time is earlier in study group than that in control group（P0.0 1）.A number of indicators of nutritional assessment in study group were much more better than that in control group both before and after bowel preparation（P0.05）.A number of laboratory parameters of study group were better than the control group after operation,with significant difference（P0.01）.Conclusion：Enteral nutrition could be applied to the preoperation bowel preparation and replace the traditional liquid diet.As a simple way,it can make the colon clear,and improve the nutrition status of the patients and decrease the post-operative complication.

关 键 词：结直肠癌 肠道准备 肠内营养 

分 类 号：R735.3[医药卫生—肿瘤]