消化道肿瘤术后早期应用含膳食纤维肠内营养的临床研究  

Clinical studies on early post-operative enteral nutrition with dietary fibers for GI tumor

作　　者：燕敏[1] 李树发[1] 李琛[1] 张俊[1] 纪福[1] 许函[1] 曹伟新[1] 

机构地区：[1]上海第二医科大学附属瑞金医院外科,上海200025

出　　处：《肠外与肠内营养》2001年第1期15-18,共4页Parenteral & Enteral Nutrition

摘　　要：目的 :探讨消化道肿瘤术后早期应用含膳食纤维肠内营养的可行性、安全性和临床效果。　方法 :6 2例伴营养不良的消化道肿瘤病人 ,随机分为肠内营养 (EN组 ,n=32 )和常规补液 (对照组 ,n=30 )两组。所有病例在营养支持前、后各测定一次体重、肝肾功能、血糖、电解质、血浆蛋白、Hb、免疫球蛋白、淋巴细胞计数和血胃泌素 ,临床观察生命体征、胃肠道功能恢复情况及各种不良反应。　结果 :所有病例在研究期间无死亡、无严重并发症、无明显肝肾功能改变。营养支持后 EN组血浆白蛋白、前白蛋白和转铁蛋白水平明显升高 (P<0 .0 5 ) ,体重下降减缓 ,血胃泌素水平在肠道营养后明显升高 (P<0 .0 5 ) ,所有病例的免疫功能均有改善 ,临床观察 EN组肛门恢复排气时间较 TPN和对照组显著缩短 (P<0 .0 5 )。　结论 :消化道肿瘤术后早期应用含膳食纤维的肠内营养支持安全、可行 ,并能改善机体营养状态 ,同时刺激胃肠道激素分泌 。Objecitves:To explore the safety,feasibility and clinical effects of early post operative enteral nutrition with dietary fibers for GI tumor. Methods:On the first post operative day,62 cases of gastrointestinal tumor were randomly divided into EN group( n =32) with early enteral nutrition(EEN) and control group( n =30) without any special nutritional therapy.A series of parameters including the body weight,the renal and liver functions,serum glucose,electrolytes,plasma proteins,Hb,immunoglobulins,lymphocyte count and serum gastrin were tested before and after nutritional therapy.The complications,vital signs,and resumption of gastrointestinal functions were carefully observed and recorded simultaneously. Results:No mortality and serious morbidity occurred for all the patients during the period of study.There was no evidence of damage of EEN to the renal and liver function.The concentrations of serum ablumin,prealbumin and transferrin were significantly elevated after nutritional support in EEN group( P <0.05),while the decline of the body weight was attenuated comparing with the control group.The serum gastrin concentration was significantly increased in EEN group( P <0.05),whereas no such changes were observed in control group.The bowel movement resumed significantly earlier in EEN group than in control group. Conclusions:Early post operative enteral nutrition for GI tumor is safe and feasible.The early enteral nutrition with dietary fibers is beneficial to improvement of nutritional status,stimulation of digestive hormone secretion and resumption of gastrointestinal function.

关 键 词：消化道肿瘤 早期肠内营养 膳食纤维 

分 类 号：R735[医药卫生—肿瘤]