肠内营养治疗对食管癌根治术后患者快速康复的效果

 目的 探讨食管癌根治术后应用肠内营养治疗对患者快速康复的效果。方法 选择2019-01至2020-06在解放军总医院第六医学中心行食管癌根治术患者60例,术中放置空肠造瘘管,术后1~7 d肠内营养速度从20 ml/h增至100 ml/h,肠内营养用量由500 ml/d增加至1000 ml/d,统计分析患者术前术后营养指标、术后并发症、禁食时间、卧床时间、造瘘管留置时间、平均住院日。结果 术前及术后白蛋白(Albumin,ALB)水平均无统计学差异;前白蛋白(Prealbumin,PAB)水平术后第1天较术前显著下降(P<0.05),术后第3天较术后第1天升高(P<0.05),术后第7天较术前差异无统计学意义。总蛋白(Total protein,TP)变化趋势与PAB类似。术后营养相关并发症发生率为23.30%,患者术后禁食时间(5.52±0.50)d;卧床时间(35.78±7.33)h;术后造瘘管平均留置时间(47.70±15.52)d;术后平均住院(9.60±2.20)d。结论 对行食管癌根治术的患者进行肠内营养支持安全、有效,有利于术后康复。

Curative effect of enteral nutrition therapy in rapid recovery after radical resection of esophageal cancer

Objective To retrospectively analyze the effect of enteral nutrition therapy on patients' rehabilitation after radical resection of esophageal cancer. Methods The clinical data on 60 patients undergoing radical esophageal cancer surgery in our hospital between January 2019 and June 2020 was retrospectively analyzed. A jejunostomy tube was placed intraoperatively. The enteral nutrition infusion rate was increased from 20 ml/h to 100 ml/h and the enteral nutrient solution dosage was increased from 500 ml/d to 1000 ml/d on d1-d7 postoperatively. Blood nutrition indexes, postoperative nutrition-related complications, fasting time, bed rest time, indwelling time of the jejunal nutrition tube, and average hospital stay were analyzed. Results Levels of total protein (TP) and prealbumin (PAB) were decreased one day after surgery (POD1), but they were increased on POD3 and POD7 compared with POD1. The albumin level hardly changed over these days. The rate of nutrition-related complications was 23.30%, with one patient developing anastomotic fistula. The patients' average fasting time was (5.52±0.50) days after operation, the average bed rest time was (35.78±7.33) hours, the average postoperative tube indwelling time was (47.70±15.52) days, and the average postoperative hospital stay was (9.60±2.20) days. Conclusions Enteral nutrition therapy after radical resection of esophageal cancer is safe and effective, which can facilitate patients' recovery from surgery.