早期肠内营养对结肠癌根治术后患者营养状态及消化道功能恢复的影响  

The effect of early enteral nutrition on the nutritional status and recovery of gastrointestinal tract function in patients with radical colectomy

作　　者：钟明霞 傅聿铭[1] 吴万庆[1] 王变丽[2] ZHONG Mingxia;FU Yuming;WU Wanqing;WANG Bianli(Department of Gastrointestinal and Thyroid Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,He’nan,China;Department of Vascular Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,He’nan,China)

机构地区：[1]郑州大学第五附属医院胃肠甲状腺外科,郑州4500520 [2]郑州大学第五附属医院血管外科,郑州4500520

出　　处：《癌症进展》2020年第3期317-320,共4页Oncology Progress

摘　　要：目的分析结肠癌根治术后早期实施肠内营养对患者营养状态及消化功能恢复的影响。方法随机数字表法将84例结直肠癌患者随机分为研究组和对照组,每组42例,研究组患者结肠癌根治术后12 h开始肠内营养支持治疗,对照组患者结肠癌根治术术后48 h开始肠内营养支持治疗。比较两组患者手术前后营养指标(血红蛋白、血清白蛋白、前白蛋白及转铁蛋白)、消化道功能恢复情况指标(术后肠鸣音恢复时间、肛门排气时间、经口进食时间、术后排便时间),比较两组患者术后并发症发生率。结果研究组患者术后肠鸣音恢复时间、肛门排气时间、经口进食时间、术后排便时间均明显短于对照组患者,差异均有统计学意义(P﹤0.01)。术后第8天,研究组患者血红蛋白、白蛋白、前白蛋白和转铁蛋白水平均高于对照组患者,差异均有统计学意义(P﹤0.05)。研究组患者并发症总发生率为9.52%(4/42),低于对照组患者的26.19%(11/42),差异有统计学意义(χ2=3.977,P﹤0.05)。结论在结肠癌根治术后早期进行肠内营养支持治疗能更好改善患者营养状态,促进消化道功能恢复,减少术后并发症发生,改善生活质量。Objective Early enteral nutrition(EN)after radical colectomy was performed,and the effect on the nutritional status and recovery of gastrointestinal tract function was analyzed.Method Eighty-six patients with primary colon or rectal cancer who underwent radical surgery were enrolled in the study and subsequently randomized to study group or control group using a random number table,with 42 cases in each.EN as supportive therapy was initiated 12 h or 24 h after radical colectomy in study group and control group,respectively.The nutritional indicators such as hemoglobin(Hb),serum albumin(ALB),prealbumin(PA),and transferrin(TFN),besides,the measures for recovery of gastrointestinal tract function,including postoperative recovery time of bowel sounds,anal exhaust time,oral feeding time,time to first defecation,as well as the incidence rate of postoperative complications were compared between the two groups.Result The recovery time of postoperative bowel sounds,anal exhaust time,oral feeding time,and time to first defecation time were significantly shorter in the study group than in the control group(P<0.01).In 8 days after surgery,the levels of HB,ALB,PA and TFN in study group were higher compared to control group,with statistically significant differences noted(P<0.05).The overall incidence rate of complications in the study group was 9.52%(4/42),which was significantly lower than the 26.19%(11/42)in control group(χ2=3.977,P<0.05).Conclusion Early application of enteral nutrition after radical colectomy helps improve the nutritional status of patients,promote the recovery of gastrointestinal tract function,reduce postoperative complications and ultimately ameliorate the quality of life for patients.

关 键 词：肠内营养 结直肠癌 根治术 营养状态 消化道功能 

分 类 号：R735.35[医药卫生—肿瘤]