食管癌患者术后不同营养治疗方式临床结局的比较  

Comparative Study on Clinical Outcomes of Postoperative Nutritional Support in Patients with Esophageal Cancer

作　　者：杨栋 罗继文 任杰 饶志勇[2] 胡雯[2] Yang Dong;Luo Jiwen;Ren Jie(Department of Clinical Nutrition,Department of Thoracic Surgery,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang,Sichuan 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院临床营养科,胸心外科,四川绵阳621000 [2]四川大学华西医院临床营养科,四川成都610041

出　　处：《四川医学》2023年第2期134-140,共7页Sichuan Medical Journal

基　　金：四川省科技计划项目(编号:2019YJ0042)。

摘　　要：目的比较和探讨不同营养治疗方式对食管癌患者术后临床结局的影响效果。方法选择2019年10月至2021年3月拟行食管癌手术治疗患者120例,随机分为三组:肠内营养(EN)组、肠外营养(PN)组和肠内联合肠外营养(PEN)组,每组40例,分别于术后第1天开始相应的营养治疗,收集并比较每组患者术后营养指标以及临床结局指标。结果EN组和PEN组患者的淋巴细胞计数均高于PN组(P<0.05);PEN组患者总蛋白、白蛋白、前白蛋白高于EN组和PN组(P<0.05),EN组和PN组比较差异无统计学意义(P>0.05);PN组肺部感染的发生率高于EN组和PEN组(P<0.05);PN组吻合口瘘发生率高于PEN组(P<0.05),EN组分别与PN组和PEN组比较,差异均无统计学意义(P>0.05);PN组患者出院时体质量明显低于术前(P<0.05),三组患者体质量丢失程度排序为:PN组>EN组>PEN组(P<0.05);PEN组住院时间短于EN组和PN组(P<0.05),EN组和PN组比较差异无统计学意义(P>0.05);PN组患者的营养治疗费及住院总费用高于EN组和PEN组(P<0.05),而EN组的营养治疗费及住院总费用与PEN组比较差异无统计学意义(P>0.05)。结论早期肠内营养联合肠外营养在术后营养治疗效果和降低肺部感染及吻合口瘘发生率、缩短住院时间、节约住院费用、减少体质量丢失等方面具有显著优势,是值得在食管癌术后患者使用并推广的营养治疗方法。Objective To compare and explore the effects of different nutritional support on postoperative clinical outcomes of patients with esophageal cancer.Methods 120 patients with esophageal cancer were selected for surgical treatment from October 2019 to March 2021,and were randomly divided into three groups:Enteral nutrition(EN)group,Parenteral nutrition(PN)group,and Enteral combined Parenteral nutrition(PEN)group,with 40 cases in each group.All patients were given the corresponding nutrition support on the first day after surgery,the nutritional indexes and clinical outcome indicators of each group were collected and compared,including the incidence of pulmonary infection,anastomotic fistula,hospitalization costs,length of hospital stay,and the weight change.Results The lymphocyte count of EN group and PEN group was higher than that of PN group(both P<0.05).The Plasma total protein,albumin and prealbumin in PEN group were higher than those in EN group and PN group(both P<0.05),but there was no significant difference between EN group and PN group(P>0.05).The incidence of pulmonary infection was higher in the PN group than that in the EN group and the PEN group(both P<0.05);The incidence of anastomotic fistula was higher in the PN group than that in the PEN group(P<0.05).Compared with the patients of EN group,there was no significant difference in the PN group and PEN group(both P>0.05).The weight of patients in PN group at discharge was significantly lower than before surgery(P<0.05);the degree of weight loss was ranked as:PN group>EN group>PEN group(all P<0.05).Patients in the PEN group spent less time in hospital than those in the EN and PN groups(both P<0.05),there was no significant difference between EN group and PN group(P>0.05).The nutrition treatment cost and total hospital expenses of the patients in the PN group were higher than those in the EN group and the PEN group(all P<0.05),but there was no significant difference between EN group and PEN group(P>0.05).Conclusion The early enteral nutrition combined wi

关 键 词：食管癌 营养治疗 临床结局 

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