肠内营养在食管癌外科快速康复中的应用

目的探讨快速康复外科理念在食管癌手术中的应用。方法自2008年7月—2010年7月对204例食管癌患者进行外科手术治疗,按病案号单双数分为2组,单数组96位患者接受快速康复外科新理念治疗-术后第1d开始肠内营养（FTS组）,双数组108位患者采用传统方法治疗（对照组）。比较2组术后首次排气、排便时间,肺部感染、吻合口瘘等严重并发症发生率。结果 FTS组：术后首次排气时间2892h,中位数52h;首次排便时间32106h,中位数70h;肺部感染发生率4.2%,吻合口瘘发生率1.1%。对照组：术后首次排气时间45132h,中位数84h,排便时间75154h,中位数92h;肺部感染发生率16.7%;吻合口瘘发生率1.9%。对照组和FTS组患者术后首次排气和排便时间、肺部并发症发生率差异均有统计学意义,吻合口瘘发生率两组间差异无统计学意义。结论 FTS新理念治疗可以有效促进食管癌术后胃肠道功能的恢复,缩短禁食时间,减少肺部感染发生率,并未增加吻合口瘘发生率。

Application of Intraintestine Nutrition in Quick Recovery of Esophagus Cancer Patients

Objective To investigate the application of fast tract surgery in patients with esophageal carcinoma.Methods From July 2008 to July.2010,204 patients with esophageal carcinoma underwent esophageal surgery.Among them,96 were treated under the guidance of fast track surgery concept,108 were managed under traditional esophageal surgery concept.The subgroups were divided randomly.Results The first patient in FTS subgroup felt flatus 28 hours after operation,the last one 92 hours,the meantime was 52 hours post operation.Defecation occurred 32 hours after operation the earliest one and 106 hours the latest one;while patients in control subgroup felt flatus 45 hours to 132 hours after operation and defecated 75 hours to 154 hours after operation.Four patients of 96 complicated pulmonary infection and one of them complicated anastomotic leakage in FTS subgroup.The pulmonary infection rate and anastomotic leakage rate in control subgroup were 16.7% and 1.9% respectively.Conclusion With the guidance of fast track surgery,patients underwent esophagectomy showed earlier recovery of gastrointestinal tract function,shorter period of fasting time and decreased pulmonary infection rate and similar anastomotic leakage rate compared with those of patients underwent traditional esophagectomy.