结肠癌患者术后肠内营养治疗  

THERAPEUTIC EFFECTS OF ENTERAL NUTRITION IN PATIENTS WITH COLON CANCER RECEVING COLOPROCTOSTOMY

作　　者：蔡东联[1] 胡同杰[1] 朱丽萍[1] 袁静珏[1] 李燕[1] 陈小莉[1] 苏峰[1] 

机构地区：[1]第二军医大学长海医院营养科中国人民解放军临床营养中心,上海200433

出　　处：《大肠肛门病外科杂志》2000年第1期1-6,共6页Journal of Coloproctological Surgery

基　　金：国家卫生部批准临床验证题.批准号为98L029

摘　　要：目的：探讨采用肠内营养对结肠癌患者术后进行营养治疗。方法：７１例住院结肠癌患者，平均年龄（５２．５３±１３．０４）岁，随机分为肠内营养治疗组（ＥＮ）和静脉营养治疗组（ＰＮ）。每天基础热能按１２５ＫＪ（３０ｋｃａｌ）／ｋｇ体重，蛋白质１.２５ｇ／ｋｇ（０．２氮／ｋｇ），热氮比值为非蛋白热能１５０ ｋｃａｌ：１ｇ氮。结果：ＥＮ组未见有恶心、呕吐、腹胀、腹泻等胃肠反应。全部患者的外部切口均Ⅰ期愈合。术前ＥＮ组４７.０６％，ＰＮ组４８．４７％的患者存在营养不良。体重、握力、ＭＡＣ、ＭＡＭＣ、ＴＳＦ、淋巴细胞总数、Ｈｂ、ＴＰ、Ａ、ＢＵＮ、ＣＲ、Ｎａ、Ｋ、Ｃｌ、血糖、Ｔｃｈ、ＴＧ等指标均在正常范围内。两组均为负氮平衡，术后第３天与第９天相比，均有显著性差异（Ｐ＜０.０５）。ＥＮ组血清谷氨酰胺和谷氨酸高于ＰＮ组，有显著性差异（Ｐ＜０.０５），其余氨基酸无差异。ＰＮ组尿Ｌ／Ｍ值升高，与ＥＮ组相比，有显著性差异（Ｐ＜０.０５）。结论：结肠癌患者术后用肠内营养治疗有明显的效果和并能维护肠屏障功能。Objective: Patients with canncer after coloproctostomy were giving the nutritional therapy using Nutren as whole nutrients. Methods: 71 cases with colon cancer were randomized into enteral nutrition group (EN) and parenteral nutrition group (PN), at average age 52.53± 13.04 yr. They were given the basic energy 125 kJ (30 kcal), protein 1.25g (0.2 gN ) per kg body weight/kg per day, and non-protein energy nitrogen ratio as 150 kcal: 1 gN. Results: There were no gut reactions in EN group such as nausea, vomit, abdomen bulge, diarrhea etc dur- ing the experiment. The incision in all sufferers were healed up Ⅰ phase. Before operation malnu- tritionin EN and PN group existed as 47.06% and 48.47%, respectively. There was no diference between before operation from after operation in EN and PN groups, such as body weight, grip, MAC, MAMc, TSF, TLC, Hb, TP, A, RUN, CR, Na, K, Cl, blood sugar, serum Tch and TG. There were differences at the negative nitrogen balance after operation between 3 rd from 9 th days in both groups (P<0.05). The serum concentrations of glutamine in EN group were notably higher than that of PN group (P<0.05). The urine L/M ratio in PN group was increased. Conclusion: Enteral nutrition can be used as an effective therapy for patiennts after coloproctostomy, and protect the gut barrier function.

关 键 词：结肠癌 肠内营养 静脉营养 手术后 

分 类 号：R459.3[医药卫生—治疗学]