食管癌术后早期肠内营养的临床研究及护理  

The clinical investigation of postoperative early enteral nutrition in patients after esophagogastrostomy and its nursing care

作　　者：沈熠[1] 张丽萍[1] 陆红艳[1] 赵美娟[1] 刘晓玉[1] 

机构地区：[1]东南大学附属江阴市人民医院胸心外科,江苏江阴214400

出　　处：《国际护理学杂志》2013年第3期460-462,共3页international journal of nursing

基　　金：江阴市新技术资助项目（20100601）

摘　　要：目的探讨食管癌切除术后早期应用肠内营养（EN）支持及护理的方法。方法190例食管癌患者行食管次全切除及胃一食管颈部吻合，术中行鼻肠管留置，术后24h起给予肠内营养制剂百普力，并行相应护理。分别于术后EN前、EN第5天、第9天检测患者的血生化及营养指标，观察患者营养支持期间，有无腹痛，腹胀，恶心，呕吐，腹泻等胃肠道不良反应。结果所有患者术中均常规操作置入鼻肠管，未发生因导管留置引起的任何并发症，全组患者均能耐受早期肠内营养，无一例发生严重并发症。EN后营养评定指标白蛋白、转铁蛋白及前白蛋白水平较EN前有明显升高，差异有显著性（P〈0．05），体重、血红蛋白、丙氨酸氨基转移酶及总胆红素无显著差异（P〉0．05）。结论食管癌术后早期肠内营养可有效改善患者营养状况，促进康复。规范化护理是保障肠内营养顺利完成的关键，可有效减少并发症的发生率。Objective To investigate the method and effect of early enteral nutrition applied in patients with esophageal cancer and summarize nursing experience. Methods A total of 190 patients with esophageal cancer had a naso-jejunal tube inserted during the opera-tion and received early enteral nutrition after operation. Peptison were infused 24 hours since the postoperative day, Serum concentration of albumin, prealbumin were examined before enteral nutrition and on the 5th, 9th, postoperative day. The recovery of bowel movement and other digestive symptoms such as abdominal pain, distension, diarrhea, nausea and vomiting were observed during the period of stud-y. Results Compared before enteral nutrition, the concentration of prealbumin, serum albumin, prealbumin and transferrin were significant- ly elevated after nutritional support in EN group （ P 〈 0. 05 ） . No severe complications occurred. However, body weight, HGb and the ser-um level of ALT and TBIL showed no significant changes （P 〉 0. 05 ） . Conclusions Early enteral nutrition can improve the nutritional sta-tus of patients with esophageal cancer and reduce the oceurence of serious postoperative complication. So, early postoperative enteral nutrition is safe , effective and economical after esophageal cancer surgery.

关 键 词：食管肿瘤 肠内营养 术后 

分 类 号：R473.73[医药卫生—护理学]