老年食管癌患者围术期营养治疗的研究  

Perioperative nutritional support for elderly patients with esophageal carcinoma

作　　者：祝鑫海[1] 具晟[1] 陈国平[1] 舒跃[1] 鲁高锋[1] 袁丰[1] 

机构地区：[1]浙江医院胸外科,杭州310013

出　　处：《浙江医学》2012年第10期760-762,共3页Zhejiang Medical Journal

摘　　要：目的 探讨老年食管癌患者围术期营养治疗的时机和方法.方法 将152 例老年食管癌手术患者根据不同的营养支持方法分为全肠外营养（TPN）组（术后第2 天起经中心静脉输注能量制剂）、肠内营养（EN）组（术后第2 天起经鼻饲营养管补充EN制剂）、围术期EN 组（术前5～7d起即予口服EN 制剂＋术后第2 天起经鼻饲营养管补充EN 制剂）,观察比较3组患者围术期血清营养指标、消化道功能恢复及术后并发症的发生情况.结果 术后予EN 治疗的2 组患者肛门恢复排气排便时间均较TPN 组缩短（P＜0.01）;术前口服EN 制剂能提高血清白蛋白和转铁蛋白水平（P＜0.05）,术后吻合口瘘及肺部感染等并发症发生率较低.结论 术后予EN 治疗可明显改善老年食管癌患者术后的营养状况,促进肠功能恢复;术前即予EN治疗效果更佳,术后感染等并发症的发生率更低.使用EN 为主适当加用肠外营养是适合老年食管癌患者术后营养支持治疗的方法.Objective To evaluate the perioperative nutrition support for elderly patients with esophageal carcinoma. Methods One hundred and fifty two elderly patients with esophageal carcinoma undergoing esophagectomy received total par- enteral nutrition （TPN group）, enteral nutrition （EN group） or perioperative enteral nutrition （PEN group） support. The serum nutri- tional index, recovery of gastrointestinal functions and postoperative complications were observed and compared among three groups. Results Postoperative exhaust time was significantly shorter（P〈0.01）;plasma albumin and transferrin levels were sig- nificantly higher （P〈0.05）; the incidence rate of short-term complications including post-operative anastomostic leakage and lung infection was lower in PEN group than those in TPN group. Conclusion The study suggests that postoperative EN treatment is an effective method to improve nutritional status, to enhance recovery of gastrointestinal function and to reduce postoperative complications for elder patients undergoing esophagectomy.

关 键 词：老年食管癌 营养治疗 围术期 营养风险 

分 类 号：R735.1[医药卫生—肿瘤]