食道癌术后不同营养支持对患者营养和卫生经济学指标的影响

目的 :评价不同的营养支持方法对食道癌术后病人营养状况和卫生经济学指标的影响 ,探讨早期肠内营养在食道癌术后营养支持的优越性。方法 :75例食道癌术后患者随机分为对照组 (n =2 5 )、肠外营养组 (PN组 ,n =2 5 )和早期肠内营养组 (EN组 ,n =2 5 ) ,分别予不同的营养支持 ,术前和术后 10d测体重 (BW )、血清白蛋白 (Alb)、前白蛋白(PA)和外周血淋巴细胞总数 (TLC) ,观察胃肠道反应 ,记录术后住院日数和总住院费用。结果 :EN组和PN组术后BW和Alb均有所下降 ,但差异无显著性 (P >0 .0 5 ) ,PA和TLC有不同程度的改善 ,但只有TLC差异有显著性 (P <0 .0 5或P <0 .0 1) ;两组的PA、TLC均高于对照组 (P <0 .0 5或P <0 .0 1) ,且EN组TLC较PN组改善明显 (P <0 .0 5 )。而对照组各指标均有不同程度的下降 ,除PA外差异均有显著性 (P <0 .0 5或P <0 .0 1)。肠内营养明显缩短术后住院日 (P<0 .0 1)和减少住院费用 (P <0 .0 5 ) ,但肠外营养只缩短术后住院日 (P <0 .0 5 ) ,减少住院费用不明显 (P >0 .0 5 ) ,组间差异有显著性 (P <0 .0 5 )。结论 :营养支持能维持在改善机体营养状况、缩短住院日和减少住院费用 ,早期肠内营养的效果更为明显。

Effects of Postoperative Nutritional Support by Different Routes on Nutritional State and Hospital Stay and Cost in Patients with Esopha geal Carcinoma

Objective:To evaluate the effects o f postoperative nutritional suppo rt by different routes on nutrition state and hospital stay and cost in patient s with esophageal carcinoma and explore the priority of early enteral nutrition . Methods:75 cases were randomized into three groups: pare nteral nutri tion (PN)group( n =25),early enteral nutrition(EN) group( n =25) and control group( n =25). Body weight, albumin, prealbumin and total lymphocytes count were monito re d on the tenth preoperative and postoperative days, hospital stay and cost were marked. Results:There were no significant differ ence between EN and PN group in body weight, albumin and prealbumin( P >0.05 ), but decrea sed significantly in control group. Total lymphocytes count of EN group was hig h er than that of PN and control group. The parameters of the control group decrdsed variable degree,there were signific ant differences except for prealbumin from EN group and PN group( P <0.05). The hospital stay and cost of EN group wer e significantly lower than that of PN and control group ( P <0.05 or P <0 .01). Conc lusion: Nutritional support especially early enteral nutrition can help to m aintain or improve the nutrition state and cut down the hospital stay and cost.