食欲刺激对结直肠癌患者术后早期肠内营养耐受性的影响  

Effect of appetite condition reflex stimulation on tolerance of early enteral nutrition after colorectal-carcinoma surgery

作　　者：李冬永 孙岩波[2] 杞映华 李建光[1] 王斌[1] 李志军[1] 岑云云[2] 徐鹏远[2] LI Dong-yong;SUN Yan-bo;QI Ying-hua;LI Jian-guang;WANG Bin;LI Zhi-jun;CEN Yun-yun;XU Peng-yuan(Department of General Surgery,the Baoshan People's Hospital,Bao Shang 678000,Yun Nan,China;Department ofGastrointestinal Surgery,the Second Affiliated Hospital of Kunming Medical University/Research Center for Surgical ClinicalNutrition of Yunnan Province,Kunming 650000,China)

机构地区：[1]保山市人民医院普外科,云南保山678000 [2]昆明医科大学第二附属医院胃肠外科/云南省外科临床营养研究中心,昆明650000

出　　处：《肿瘤代谢与营养电子杂志》2018年第4期366-371,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：云南省外科临床营养研究中心基金项目(2017NS302)

摘　　要：目的探讨食欲条件反射刺激对结直肠癌术后患者接受术后早期肠内营养治疗的耐受性、肠内营养并发症及术后住院时间的影响。方法纳入昆明医科大学第二附属医院胃肠外科2017年2月～12月期间行腹腔镜结直肠癌根治术患者70例(结肠癌42例,直肠癌28例),随机分为刺激食欲组(试验组)和常规治疗组(对照组)各35例,两组患者均实施EEN,对比分析两组患者术后EEN的耐受性、手术并发症的发生率、普通饮食恢复时间、术后住院时间。结果 66例患者完成试验,其中试验组34例,对照组32例。试验组术后EEN的耐受性较对照组有改善(恶心、呕吐、腹胀、使用促胃肠动力药物、胃管重置率明显少于对照组, P <0.05);试验组较对照组普通饮食恢复时间(5.0±1.0d vs 6.4±1.9d)、术后住院时间(7.0±2.0d vs 8.0±1.8d)缩短(P <0.05);两组并发症差异无统计学意义(P> 0.05)。结论食欲条件反射刺激能提高结直肠癌患者术后EEN的耐受性,缩短普通饮食恢复时间,缩短住院时间,不增加手术并发症的发生率,是一组简单、易行、经济的加快患者术后康复的措施。Objective This study aims to discuss effects of appetite condition reflex stimulation on early enteral nutrition tolerance,complications and postoperative hospital stay of patients after colorectal-carcinoma surgery.Methods A total of 70 patients(42 cases of colon cancer and 28 cases of rectal cancer)scheduled for laparoscopic colorectal cancer surgery in department of gastrointestinal surgery,the 2th Affiliated Hospital of Kun Ming Medical University from February to December,2017 were divided into stimulate appetite group(experimental group,n=35)and conventional treatment group(control group,n=35)randomly.Both of the two groups were treated with EEN,and the tolerance of EEN,the rate of surgery complications and the time of postoperative hospital stay were compared respectively.Results There were 66 cases,including 34 cases in experimental group and 32 cases in control group,were finished the relevant experiment.Patients in experimental group had better tolerance of EEN than patients in control group(rates of nausea,vomiting,bloating,use of prokinetic drugs,and gastric tube replacement were lowers than control group,P<0.05),and shorter time to tolerate regular eating(5.0±1.0 d vs.6.4±1.9 d in control group,P<0.05)and shorter time of postoperative hospital stay(7.0±2.0 d vs.8.0±1.8 d in control group,P<0.05).No significant difference of complication was detected(P >0.05).Conclusions Appetite condition reflex stimulation can improve tolerance of EEN,shorten time to ordinary diet recovery and shorten time of hospital stay,does not increase the incidence of surgical complications,so it is a group of simple,feasible,safety and economical measures to enhance patients recovery after surgery.

关 键 词：早期肠内营养 耐受性 结直肠癌 

分 类 号：R735.34[医药卫生—肿瘤]