食管癌术后早期肠内营养与肠外营养预防相关感染效果比较  

Comparison on effects between early enteral nutrition and parenteral nutrition in prevention of postoperative infections in patients with esophageal carcinoma

作　　者：张少娟[1] 吕定量[1] 万海军[1] 盛红娜[1] 邱欣 

机构地区：[1]衢州市人民医院心胸外科,浙江衢州324000

出　　处：《中华医院感染学杂志》2017年第24期5618-5621,共4页Chinese Journal of Nosocomiology

基　　金：浙江省中医药科学研究基金资助项目(2015ZA216)

摘　　要：目的比较食管癌术后早期肠内营养与肠外营养在预防感染中的效果,为医院感染的预防和控制工作提供客观依据。方法选取2013年1月-2017年6月于医院行食管癌切除术的100例患者为研究对象,分为试验组和对照组,每组各50例。术后,对照组患者给予全静脉肠外营养支持治疗,试验组患者给予早期肠内营养支持治疗。观察比较两组患者的术后感染率、术后排气时间和体质量下降水平。对两组患者术后1d、7d时的血清白蛋白(ALB)、血红蛋白(Hb)水平等营养指标及外周血淋巴细胞亚群指标进行检测和比较。结果试验组患者的术后总感染率为8.00%,低于对照组患者的24.00%(P<0.05);治疗后,试验组患者的血清ALB、Hb水平及外周血CD_4^+、CD3+、CD_8^+、CD_4^+/CD_8^+优于对照组患者(P<0.05);试验组患者的排气时间和体质量下降水平低于对照组患者(P<0.05)。结论相对肠外营养支持治疗,在食管癌切除术后应用早期肠内营养支持治疗,能够降低患者术后感染率,改善患者的营养状态和细胞免疫功能指标,减少手术创伤,促进患者胃肠功能的恢复。OBJECTIVE To compare effects between early enteral nutrition and parenteral nutrition in prevention of postoperative infections in patients with esophageal carcinoma,so as to provide an objective basis for the prevention and control of nosocomial infections.METHODS A total of 100 patients treated with esophageal carcinoma resection from Jan.2013 to Jun.2017 were selected as the research subjects and randomly divided into observation group and control group,with 50 cases in each group.The patients in control group were treated with intravenous parenteral nutrition support treatment,while in observation group were treated with early enteral nutrition treatment.The incidences of postoperative infections,postoperative exhaustion time and body weight loss of patients in the two groups were observed and compared.The nutrition indicators of serum albumin（ALB）,hemoglobin（Hb）levels and the indicators of peripheral blood lymphocyte subgroups at 1 dand 7 dafter the operation of patients in the two groups were detected and compared.RESULTS The incidences of postoperative infection of the patients in observation group was 8.00%,which was significantly lower than 24.00% in control group（P 〈0.05）.After treatment,the serum ALB and Hb levels and CD4＋,CD3＋,CD8＋,and CD4＋/CD8＋in the peripheral blood in observation group were significantly better than those in control group（P〈0.05）.The exhaustion time and the body weight loss of patients in observation group were significantly lower those in control group（P 〈0.05）.CONCLUSIONCompared with application of parenteral nutrition support treatment,application of early enteral nutrition support treatment after the esophageal carcinoma resection can reduce the incidence of postoperative infections,improve the nutritional status and immune function indicators of patients,reduce surgical trauma,and promote the recovery of gastrointestinal function of patients.

关 键 词：食管癌 早期肠内营养支持治疗 术后感染 预防 

分 类 号：R619.3[医药卫生—外科学]