早期肠内营养支持对喉癌术后病人营养状况的改善作用  

Early enteral nutritional support in patients after laryngeal cancer surgery

作　　者：郭静[1] 黎娜[1] 范杨[1] 刘洁[1] 孙海岚[1] 蒋宝泉[1] 杨剑[1] 许红霞[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所营养科,重庆400042

出　　处：《肠外与肠内营养》2014年第3期132-134,共3页Parenteral & Enteral Nutrition

基　　金：重庆市科委重点攻关项目资助(2011AB5038)

摘　　要：目的:观察早期肠内营养(EEN)支持对喉癌病人术后的临床效果。方法:对行喉癌手术的77例病人术后12 h开始经鼻胃管给予EN支持,并对病人术前和术后第1、4、7和14天的血清清蛋白(ALB)、前清蛋白(PA)、血红蛋白(Hb)和淋巴细胞总数(LYM)进行比较,同时观察术后感染和咽瘘的发生情况。结果:术后第1天,病人的ALB、PA、Hb和LYM明显下降,术后第4天,ALB和LYM逐渐回升,而PA和Hb进一步下降,至术后第7和14天才逐渐回升。术后第14天PA恢复至正常值水平,而ALB、Hb和LYM仍处于较低水平。但各项指标与术后第1天比均有明显升高(P<0.05)。有7例病人术后给予EN液后出现腹胀、腹泻等不良反应。术后感染率为11.49%(11/77)。咽瘘发生率为5.19%(5/77)。结论:喉癌手术后行EEN支持可明显改善病人的营养状况。Objective：To evaluate the efficiency of early enteral nutritional support in the postoperative care of patients after larynegectomy.Methods：All patients who were confirmed by pathological examination after total or partial laryngectomy in Daping Hospital between July,2011 and May,2012 were included in this study.Early enteral nutrition was started through the nasogastric tube 12 hr after the end of surgery.Albumin （ALB）,prealbumin （PA）,hemoglobin （Hb）,the total number of lymphocytes （LYM） in the blood were checked in the 1st,4th,7th and 14th day after surgery.Results：77 patients were included.ALB,PA,Hb,and LYM were relatively normal before the surgery.ALB,PA,Hb,LYM were significantly decreased on 1 st d after surgery.PA and Hb were decreased,but ALB and LYM were increased on 4th d after surgery by the enteral nutritional support.ALB,PA,Hb,and LYM were all increased on 7th d and 14th d.7 patients appeared abdominal distension and diarrhea.They finally tolerated gradually by adjusting injection velocity and concentration of nutrients.11 patients got wound infection.5 patients developed to pharingocutaneous fistula.Conclusion：The early enteral nutritional support can improve postoperative nutritional status in patients after total or partial Laryngectomy.

关 键 词：喉癌全切术 喉癌次全切术 肠内营养 咽瘘 

分 类 号：R739.65[医药卫生—肿瘤] R459.3[医药卫生—临床医学]