胃肠道恶性肿瘤术后早期肠内营养支持的临床意义

目的 :探讨胃肠道恶性肿瘤术后早期肠内营养支持的可行性及其临床意义。方法 :将 40例胃和大肠癌病人随机分为完全胃肠外营养支持组 (TPN组 )和肠内营养支持组 (EN组 )。TPN组术后行标准的全胃肠外营养支持 7d ;EN组在手术后第 1天 (2 4h内 )经鼻肠管或空肠造口管输入肠内营养液能全力 ;两组提供的热量和氮量完全相同。记录术后并发症 ,肠鸣音恢复时间 ,住院天数和营养支持的总费用情况 ;于术前和术后第 8天检测病人体重、上臂周经、血红蛋白 (Hb)、淋巴细胞 (LC)计数、血浆总蛋白 (TP)和白蛋白 (ALB)。结果 :两组病人无死亡、消化道瘘和腹腔感染等严重并发症。EN组肠动力恢复早于TPN组 ,节约营养支持费用 (P <0 .0 5 ) ;两种方法营养支持疗效相近 ,体重等 6项基本营养指标手术前后和两组间无差异 (P <0 .0 5 )。结论 :胃肠道恶性肿瘤病人术后早期EN的营养支持效果与TPN基本相同 ,具有方便和经济的优点。

The clinical significance of postoperative early enteral nutrition in patients with malignant gastrointestinal tumor

Objective:To study the feasibility and the clinical significance of postoperative early enteral nutrition in patients with malignant gastrointestinal tumor.Methods:Forty cases of gastric and colorectal cancer were randomly divided into two groups,TPN group and EN group.After operation,the patients of TPN group were given standard total parenteral nutrition for 7 days,in EN group,on the first postoperative day,Nutrison Fibre were given via nasal lintestinal tube or jejunum tube.Energy and nitrogen were similar in the two groups.We registered the postoperative complication,time of resuming peristaltic sound,hospital-stay time and total fee for nutrition.Before operation and on the eighth postoperative day,we measured body weight,perimeter of the upper arm,Hb,number of LC,TP,and ALB.Results:In the two groups,there were no death,no fistula,no abdominal infection and other complications.EN group was more favourable to resume intestinal peristalsis and save spending than TPN group (P<0.05).The curative effect of EN and TPN was similar ,there was no difference in the basic nutrition index before and after operation(P>0.05).Conclusion:Early enteral nutrition after operation is conveninent,feasibible,economical,and the curative effect is similar to TPN.