术后早期经口肠内营养对结直肠癌患者临床结局的影响

目的探讨术后早期肠内营养对结直肠癌患者临床结局的影响。方法前瞻性入组2012年1-5月问青岛大学医学院附属医院普通外科收治的48例结直肠癌患者，按随机数字表法随机分为试验组和对照组，每组24例。试验组患者术后早期少量多次进水加肠内营养制剂（佳维体）；对照组患者采用常规围手术期治疗方案，比较两组患者术后恢复情况、并发症发生率、营养状况及免疫功能。结果与对照组相比，试验组患者术后肛门排气时间明显加快（54.3±11．9）h比（65．7±10．0）h，P〈0．05]，术后住院时间明显缩短（5．4±1．1）d比（7．1±1．4）d，P〈0．05]，住院费用明显减少（3．63±0．64）万元比（4．28±0．43）万元人民币，P〈0．05]，两组术后并发症发生率的差异无统计学意义12．5％（3／24）比16．7％（4／24），P〉0．05]。术后第5天，试验组总蛋白、白蛋白及前白蛋白等营养指标明显高于对照组，CRP、IL-6及TNF-a等炎性反应指标明显低于对照组（均P〈0．05）。结论术后早期肠内营养能够改善结直肠癌患者营养状况及免疫功能，促进肠道功能早期恢复。

Effect of early oral enteral nutrition on clinical outcomes after colorectal cancer surgery

Objective To investigate the effect of early oral feeding with enteral nutrition after surgery on clinical outcomes in patients with colorectal cancer. Methods Forty-eight patients with colorectal cancer undergoing elective operation between January 2012 and May 2012 were randomly divided into study group （n=24） and control group （n=24）. Patients in the group were given small amount of water several times and enteral nutrition early after surgery. Patients in the control group received conventional postoperative care protocol. Nutritional status, immune function, time of flatus, postoperative hospital stay, medical cost and incidence of complications between the two groups were compared. Results As compared to the control group, nutritional status and immune function in the study group were significantly better（P〈O.05）. In the study group, time to flatus（54.3±ll.9）h vs. （65.7±10.0）h, P〈0.05] and postoperative hospital stay （5.4±l.1）dvs. （7.1±1.4） d, P〈0.05] were significantly shorter, and medical cost （36.3±6.4） thousand RMB vs. （42.8±4.3） thousand RMB, P〈0.05] was significantly less as compared with the control group. No difference of the complication incidence was found 12.5%（3/24） vs. 16.7%（4/24）, P〉0.05]. Conclusion Early oral feeding with enteral nutrition after surgery can improve the nutritional status and immune function, and accelerate the recovery of patients with colorectal cancer.