食管癌术后早期肠内营养联合肠外营养与标准肠外营养支持的疗效对比  

Comparison of Early Enteral Nutrition Combined with Parenteral Nutrition and Standard Parenteral Nutrition after Esophageal Cancer Surgery

作　　者：马经伟[1] 王涛[1] 吴波 叶晓锋[1] MA Jingwei;WANG Tao;WU Bo;YE Xiaofeng(Department of Oncology,the General Hospital of Ningxia Medial University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院肿瘤外科,银川750004

出　　处：《宁夏医科大学学报》2020年第2期163-167,共5页Journal of Ningxia Medical University

基　　金：宁夏回族自治区科技支撑计划项目(2015BY072)。

摘　　要：目的评估并比较食管癌术后早期经鼻-空肠营养管置入开展肠内营养与标准肠外营养的临床疗效。方法将78例食管癌患者根据营养支持方式分为观察组与对照组。观察组40例,采用经鼻-空肠营养管置入进行肠内营养+标准肠外营养支持治疗;对照组38例,采用单纯肠外营养支持治疗。通过观察两组患者术后营养状况,评估并比较患者通气时间、并发症发生情况、炎症反应、血白蛋白、总蛋白、血红蛋白等指标,分析营养支持的临床疗效和应用安全性。结果本组所有患者均无术后死亡。观察组40例均成功置入鼻-空肠营养管,无严重营养管置入相关不良反应。观察组术后并发症发生率(12.5%)与对照组(15.8%)差异无统计学意义(P>0.05);观察组患者术后肛门排气时间短于对照组,营养支持时间长于对照组(P均<0.05);观察组患者术前血总蛋白、白蛋白、血红蛋白水平与对照组相比差异无统计学意义(P均>0.05)。术后两组患者血生化指标均低于术前(P均<0.05)。营养支持治疗后,观察组患者血总蛋白、白蛋白回升幅度大于对照组(P均<0.05),血红蛋白水平维持稳定(P>0.05)。结论食管癌术后早期经鼻-空肠营养管置入疗效好、耐受性好、且能促进肠道功能恢复,促进蛋白合成代谢,是食管癌术后营养支持的首选方法。Objective To evaluate the clinical effect of the nasal-jejunal tube placement for early enteral nutrition in postoperative patients with esophageal cancer and compare with standard parenteral nutrition.Methods Totally 78 patients with esophageal cancer were divided into observation group and control group according to nutritional support.The 40 cases in the observation group received enteral nutrition plus standard parenteral nutrition support with the placement of nasal-jejunal nutrition tube,while 38 cases in the control group received simple parenteral nutrition support.By observing the nutritional status of the patients in the two groups,first fecal passage,incidence of infection complications,inflammatory reaction,serum total protein,albumin,and hemoglobin levels were all evaluated to analyze the clinical efficacy and application safety of nutritional support.Results No operative death was observed in the group.The naso-jejunal nutrition tube was successfully implanted in 40 patients in the observation group,and there were no serious adverse reactions related to the placement of nutrition tube.The incidence of complications in the observation group(12.5%)was not significantly different from that in the control group(15.8%)(P>0.05).The fecal passage time in the observation group was shorter than that in the control group,and the nutritional support time was longer than that of the control group(P all<0.05),There was no significant difference in the levels of serum total protein,albumin and hemoglobin between the observation group and the control group before operation(P all>0.05).The blood biochemical indexes of the two groups after operation were lower than those before operation(P all<0.05).After nutritional support treatment,the recovery of serum total protein and albumin in the observation group was significantly higher than that in the control group,the difference was statistically significant(P all<0.05),and the serum hemoglobin level in the observation group remained stable(P>0.05).Conclusion Early pla

关 键 词：食管癌 鼻-空肠营养管 肠内营养 肠外营养 

分 类 号：R735.1[医药卫生—肿瘤]