不同营养支持方案对直肠癌患者术后发生肠梗阻影响的研究  

Different Nutritional Support Program Impact on Postoperative Ileus Occurs in Patients With Colorectal Cancer

作　　者：边志民[1] 

机构地区：[1]中国医学科学院肿瘤医院综合科,北京100029

出　　处：《中国卫生标准管理》2015年第14期95-98,共4页China Health Standard Management

摘　　要：目的探讨肠内营养和肠外营养支持方案对直肠癌患者术后发生肠梗阻影响。方法选取在本院住院治疗的直肠癌患者158例,本研究根据患者术后接受的营养方式不同将患者分为肠内营养组(EN组)和肠外营养组(PN组),每组79例患者,肠内营养组接受鼻肠营养管给予营养,肠外营养组接受锁骨下静脉给予营养,比较两组患者术后早期,延长型以及后期肠梗阻的发生情况;比较两组患者的首次排气和首次排便的时间;比较两组患者的术后并发症的发生情况;比较两组患者的住院时间。结果 EN组患者发生肠梗阻的比例(21.52%)低于PN组(37.97%)(t=5.086,P=0.024),EN组患者发生早期肠梗阻的比例(6.33%)低于PN组(16.46%)(t=3.987,P=0.046),且差异具有统计学意义;EN组患者首次排气时间(93.16±8.97h)短于PN组(117.02±14.04)h(t=29.373,P=0.000),EN组患者首次排便时间(100.16±10.26)h短于PN组(124.27±16.37)h(t=21.766,P=0.000)且差异均具有统计学差异;EN组患者术后感染并发症的总比例(16.46%)低于PN组(32.91%),EN组患者术后吻合口瘘的发病率(0%)低于PN组(7.59%)(t=6.197,P=0.013),且差异具有统计学意义;EN组患者ICU治疗时间(2.44±0.92)d低于PN组(3.61±1.45)d(t=3.054,P=0.000),EN组患者总住院时间(14.26±2.51)d低于PN组(17.52±3.27)d(t=4.057,P=0.000)且差异具有统计学意义。结论给予直肠癌患者术后早期肠内营养支持,不仅可以有效的降低肠梗阻的发生,对于广泛性直肠癌患者还可以有效的降低吻合口瘘的发生的可能性。Objective To investigate the enteral nutrition and parenteral nutrition support programs on the postoperative ileus occurs in patients with colorectal cancer.Methods Patients with colorectal cancer in our hospital treated 158 cases of this study were divided into different groups of enteral nutrition（EN group）and parenteral nutrition group（PN group）according to postoperative patients receiving nutritional way,each 79 patients,enteral nutrition group received nasal feeding tube to give intestinal nutrition,parenteral nutrition group received intravenous nutrition subclavian,early postoperative period,extending type and occurrence of late obstruction between the two groups of patients,two groups were compared first exhaust and the first defecation time,the incidence of postoperative complications between the two groups of patients,the hospital stay of patients were compared.Results EN group the proportion of patients with intestinal obstruction （21.52%） was significantly lower than the PN group（37.97%）（t=5.086,P=0.024）,EN group of patients with early intestinal obstruction proportion（6.33%） was significantly lower in the PN group（16.46%）（t=3.987,P=0.046）,and the difference was statistically significant,EN group were first exhaust time（93.16±8.97h）was significantly shorter than the PN group（117.02±14.04h）（t=29.373,P=0.000）,EN group were first defecation time（100.16±10.26h）was significantly shorter than the PN group（124.27±16.37h）（t=21.766,P=0.000）,and the differences were statistically significant,the total percentage of EN postoperative infection complications（16.46%）was significantly lower than the PN group（32.91%）,the incidence of postoperative anastomotic fistula EN group（0%）was significantly lower than the PN group（7.59%）（t=6.197, P=0.013）,and the difference was statistically significant,EN treatment time ICU patients（2.44±0.92）d was significantly lower than the PN group（3.61±1.45）d（t=3.054,P=0.000）The total length of

关 键 词：肠内营养 肠外营养 直肠癌 肠梗阻 

分 类 号：R574[医药卫生—消化系统]