食管癌患者的营养状况及治疗  

Nutrition status of patients with esophageal cancer and its management

作　　者：齐淑静[1] 齐瑞霞 张午临 孙宇航[1] 康艳辉[3] 李伟 付泽娴[1] 杨福申[1] 霍忠超[1] 卢佳慧[1] 于晓娟[1] 张宝霞[1] 任勇[1] 张金风 QI Shu-jing;QI Rui-xia;ZHANG Wu-lin;SUN Yu-hang;KANG Yan-hui;LI Wei;FU Ze-xian;YANG Fu-shen;HUO Zhong-chao;LU Jia-hui;YU Xiao-juan;ZHANG Bao-xia;REN Yong;ZHANG Jin-feng(Affliated Hospital of Hebei University of Engineering, Handan 056002, Hebei, China;Handan Central Hospital, Handan 056000, Hebei, China;Medical College of Hebei University of Engineering, Handan 056002, Hebei, China)

机构地区：[1]河北工程大学附属医院,河北邯郸056002 [2]邯郸市中心医院,河北邯郸056000 [3]河北工程大学医学院,河北邯郸056002

出　　处：《肿瘤代谢与营养电子杂志》2018年第1期107-110,共4页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：邯郸市科技局计划内项目(1623208061-3)

摘　　要：食管癌是我国常见的恶性肿瘤之一,在我国恶性肿瘤的发病率及死亡率分别为第5位和第4位,并且呈逐年上升趋势。营养治疗对食管癌患者具有重要作用。食管癌患者由于梗阻、吞咽困难、肿瘤消耗等因素易造成蛋白质、脂肪、碳水化合物、维生素和矿物质以及液体摄入量不足,引起营养不良的情况进一步加重。营养不良增加术后并发症发生率,影响患者术后康复和后续治疗。营养治疗的正确使用,是外科医生和医学肿瘤学家的重要组成部分。肿瘤科医生应该意识到食管癌患者是营养不良相关并发症的高危人群。而超重和肥胖明确的增加手术并发症风险,体重降低不仅与手术的风险有关,还与化疗、放疗和综合治疗依从性差有关。这最终转化为在较差的恢复率和较低的治愈率。口服营养补充是一个简单的程序,但需与营养专家紧密配合。管饲喂养,随着商业配方的使用,为不适合口服营养补充的患者提供适量的宏观和微量元素。在围手术期营养治疗的条件下,应有限应用经皮胃造瘘术,因为它已被广泛应用在各个领域尤其是在胃肠道肿瘤的外科手术。充分利用EN或PN能够减少并发症发生率和缩短住院时间。Esophageal cancer is one of the most common malignant tumors in China. The morbidity and mortality of malignant tumors in China are the 5th and 4th places respectively, and they are increasing year by year. Nutritional support plays an important role in patients with esophageal cancer. Due to factors such as obstruction, diffculty in swallowing, tumor consumption,？esophageal cancer patients can easily lead to insuffcient intake of protein, fat, carbohydrate, vitamins and minerals and fuid, and thus cause malnutrition situation even worse. Malnutrition increases the incidence of postoperative complications, which affects postoperative rehabilitation and follow-up treatment. The proper use of nutritional support is an important component of surgeons and medical oncologists. Oncologists should be aware that patients with esophageal cancer are at high risk for complications related to malnutrition. While overweight and obesity clearly increase the risk of surgical complications, weight loss is not only associated with the risks of surgery, but also with chemotherapy, radiotherapy and comprehensive treatment compliance. This eventually turns out to be lower recovery rates and cure rates. Oral nutrition supplement is a simple procedure which needs work closely with nutrition experts. Tube feeding, with the use of commercial formulations, provides adequate macro and trace elements for patients who are not suitable for oral nutrition supplements. In the context of perioperative nutritional support, PEG should be limited because it has been widely used in various felds, especially in gastrointestinal tumors. Full use of EN or PN can reduce the incidence of complications and can shorten hospital stay.

关 键 词：营养治疗 食管癌 口服营养补充 肠内营养 肠外营养 

分 类 号：R459.3[医药卫生—治疗学] R735.1[医药卫生—临床医学]