肠内营养联合聚乙二醇在结直肠癌伴肠梗阻患者术前肠道准备中的应用效果  

Effect of enteral nutrition combined with polyethylene glycol on bowel preparation for colorectal cancer patients with intestinal obstruction

作　　者：朱州[1] 钟晓刚[1] 何艳 Zhu Zhou Zhong Xiaogang He Yan.(Department of Gastrointestinal Surgery, The People＇s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, China)

机构地区：[1]广西壮族自治区人民医院胃肠外科,广西南宁530021

出　　处：《结直肠肛门外科》2017年第4期465-469,共5页Journal of Colorectal & Anal Surgery

基　　金：广西壮族自治区卫生厅科研课题;编号:Z2010251

摘　　要：目的研究肠内营养联合聚乙二醇用于结直肠癌伴肠梗阻患者术前肠道准备的临床效果。方法回顾性分析本院2014年10月至2016年10月收治的80例结直肠癌伴肠梗阻患者临床资料,按照术前肠道准备的不同,分为观察组(行肠内营养联合聚乙二醇肠道准备,n=40)及对照组(行单纯聚乙二醇肠道准备,n=40)。两组术前均置入肛肠梗阻导管,减压灌洗引流,术后均给予肠内营养支持。比较两组肠道清洁效果,记录两组术后胃肠道功能恢复情况、并发症及营养状况。结果所有患者置入肠梗阻导管均获得成功,两组肠道清洁效果差异无统计学意义(P>0.05)。观察组术后首次排气时间、排便时间均显著短于对照组,差异均有统计学意义(均P<0.05)。观察组并发症总发生率显著低于对照组(P<0.05)。术前,两组血清总蛋白(serum total protein,STP)、前白蛋白(prealbumin,PA)及转铁蛋白(transferrin,TRF)差异均无统计学意义(均P>0.05)。术后1 d及术后1 w,对照组STP、PA及TRF水平均显著低于术前(均P<0.05)。观察组术后1 d各营养指标均显著低于术前(均P<0.05),术后1 w时各指标与术前差异均无统计学意义(均P>0.05)。术后1 w,观察组各指标水平均显著高于对照组,差异均有统计学意义(均P<0.05)。结论肠内营养联合聚乙二醇方案用于结直肠癌伴肠梗阻患者术前的肠道准备,可获得满意的肠道清洁效果,且术后并发症少,胃肠道功能和营养状况恢复快,有助于术后早期康复。Objective To study the clinical effect of enteral nutrition combined with polyethylene glycol on preoperative intestinal preparation in colorectal cancer patients complicated with intestinal obstruction. Methods The clinical data of 80 colorectal cancer patients with intestinal obstruction treated in our hospital from October 2014 to October 2016 were analyzed retrospectively. According to preoperative bowel preparation, they weredivided into observation group（enteral nutrition combined with bowel preparation, n = 40）and control group（treated with polyethylene glycol bowel preparation, n = 40）. Anorectal obstruction catheter, decompression irrigation and drainage were performed in the two groups. All patients were given enteral nutrition support after operation. The effect of intestinal cleaning was comparedbetween the two groups.The recovery of gastrointestinal function, complicationsand nutritional status were recorded in the two groups after operation. Results All the patients were successfully treated with intestinal obstruction, and there was no significant difference between the two groups in the effect of cleaning（P 〈 0.05）. The first exhaust time and defecation time of the observation group were significantly shorter than that of the control group, the difference was statistically significant（P 〈 0.05）. The total incidence of complications in the observation group was significantly lower than that in thecontrol group（P 〈 0.05）.The difference of serum total protein（STP）, prealbumin（PA） and transferrin（TRF） between the two groups had no statistically significant（P 〈 0.05）.After 1 day and 1 week after operation, the levels of STP, PA and TRF in the control group were significantly lower than those before operation（P 〈 0.05）. The nutritional indexes of the observation group after 1 day were significantly lower than those before operation（all P 〈 0.05）, and there was no obviously difference between the indexes at 1 week and the preoperative（P 〈 0.05�

关 键 词：结直肠癌伴肠梗阻 肠道准备 肠内营养 聚乙二醇 

分 类 号：R735.34[医药卫生—肿瘤]