家庭肠内营养支持在食管癌根治术患者中应用的效果  

Effects of home enteral nutrition for post-operative patients of esophageal cancer

作　　者：童雅萍[1] 郎秀清[1] 谢玲女[2] 沈祝苹[1] 陈伟琴[1] 宋灵兰[3] Tong Yaping;Lang Xiuqing;Xie Lingnv;Shen Zhuping;Chen Weiqin;Song Linglan(Deparment of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China;Department of Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China;Department of Diet and Nutrition, Zhejiang Cancer Hospital, Hangzhou 310022, China)

机构地区：[1]浙江省肿瘤医院胸外科,杭州310022 [2]浙江省肿瘤医院大外科,杭州310022 [3]浙江省肿瘤医院膳食营养科,杭州310022

出　　处：《中华现代护理杂志》2018年第11期1292-1296,共5页Chinese Journal of Modern Nursing

基　　金：浙江省医药卫生计划项目（2016KYB044）

摘　　要：目的 探讨食管癌根治术患者出院后实施家庭肠内营养支持的方法及效果.方法 2016年1月—2017年3月选择某院胸外科早期食管癌根治术＋空肠造瘘术患者85例作为研究对象,按随机数字表法分为观察组（n=44）与对照组（n=41）.对照组患者出院后经营养评估,常规经口进食普通居家膳食,空肠造瘘管夹管.观察组患者出院后经营养评估,除经口进食普通居家膳食外,在专业营养支持小组的指导下给予肿瘤专用免疫型肠内营养制剂经空肠造瘘管饲.测定两组实验室血清营养指标、欧洲营养风险筛查2002（NRS 2002）得分,统计分析两组出院时和干预1个月后各指标的差异.结果 两组患者出院时各项指标比较差异无统计学意义（P〉0.05）.干预1个月后,观察组血红蛋白、血清总蛋白、血清白蛋白、血清前白蛋白、转铁蛋白水平均优于对照组[（12.90±1.33）vs.（10.83±1.35）g/dl,（72.22±4.83）vs. （63.90±5.44）g/L,（41.63±2.67）vs.（36.98±3.69）g/L,（217.70±56.72）vs.（166.27±39.97）mg/L, （2.41±0.38）vs.（1.76±0.47）g/L],两组差异均有统计学意义（P〈0.01）.1个月后,观察组具有高度营养风险（NRS 2002得分≥3分）的患者比例（45.5%）低于对照组（68.3%）,两组差异有统计学意义（P〈0.05）.结论 对出院后的食管癌根治术患者实施家庭肠内营养支持,能明显改善患者的营养状况,降低术后营养不良风险率,提高手术治疗效果.Objective To explore the method and efficacy of home enteral nutrition for patients undergoing radical resection of esophagus cancer. Methods A total of 85 patients who underwent radical surgery for esophageal cancer and jejunum fistula from January 2016 to March 2017 were enrolled and were divided into observation group （n=44） and control group （n=41） by random number table method. Patients of control group took normal family diet orally after nutrition assessment and jejunum fistula clipped while patients of observation group received extra special immune enteral nutrition preparations for tumor through fistula of jejunostomy under the guidance of a nutrition support team. After one month treatment, plasma nutrition indicators and European Screening for Nutrition Risk （NRS 2002） assessment were performed to analyze the difference of two groups to compare the nutrition status. Results All indicators did not differ when discharged for two groups （P〉0.05）. After one month intervation, level of hemoglobin, total serum protein, albumin, prealbumin and transferrin of the observation group were statistically higher than those of control group [（12.90±1.33） vs. （10.83±1.35）g/dl, （72.22±4.83） vs. （63.90±5.44）g/L, （41.63±2.67） vs. （36.98±3.69）g/L,（217.70±56.72） vs. （166.27±39.97）mg/L,（2.41±0.38） vs. （1.76±0.47）g/L; P〈 0.01]. Percentage of patients with high nutritional risk （NRS 2002 ≥3） in the observation group was lower than that of the control group （45.5% vs. 68.3%; P〈0.05）. Conclusions Nutritional support at home after discharge could improve the nutritional status and reduce the risk of malnutrition for patients who underwent radical surgery for esophageal cancer.

关 键 词：食管肿瘤 延续护理 家庭肠内营养 营养风险 

分 类 号：R473.2[医药卫生—护理学]