术后早期肠内营养在食管癌患者中的应用

目的探讨术后早期肠内营养在食管、贲门癌患者中应用的安全性和临床价值。方法将72例食管、贵门癌患者随机分为肠内营养组（EN纽）36例和常规输液纽（对照组）36例，分别比较营养支持前后两组患者的生命体征、胃肠功能恢复情况和各种不良反应的发生率，以及体质量、血浆蛋白、血糖、肝肾功能、电解质和免疫球蛋白等指标的变化。结果所有病例均未发生手术死亡和严重并发症，肝肾功能等生化指标无显著变化。但EN组血浆白蛋白、前白蛋白和转铁蛋白（34．9±3．5）g／L、（216．3±37．1）g／L和（166．5±49．3）mg／L，在肠内营养支持7天后上升至（41．3±5．8）g／L、（294．7±44．5）g／L和（186．3±37．5）rag／L（均P〈0．01）；对照组则无显著变化。EN组患者的免疫功能也在肠内营养支持后明显改善（P〈0．01）。结论食管、贲门癌患者术后早期应用肠内营养支持安全可行，有明显的改善营养状况、提高免疫功能的作用。

Application of enteral nutrition in postoperative carcinoma of esophagus patients

Objective To evaluate the safety and clinical value of early postoperative enteral nutrition in esophageal and cardiac cancer patients. Methods 72 patients of esophageal and cardiac cancer were randomly divided into two groups, enteral nutrition group（EN group） 36 patients and routine group（control group） 36 cases. The vital signs,resumption of gastrointestinal function, and complications after operation were carefully observed. The body mass,plasma protein, fasting glucose, liver and renal functions, electrolytes and immunogiobin before and after nutritional support were compared between the two groups. Results Neither of two groups bad death after operation or severe complications. The liver and renal functions did not change, but EN group showed significant elevation of plasma protein, transferrin and prealbumin 7 days after nutritional support, respectively, by the nutritional support before （34.9± 3.5） g/L, （216.3±37.1） g/L and （166.5±49.3） mg/L,rose to （41.3±4 5.8） g/L, （294.7±44.5） g/L and （186.3±37.5） mg/I.（all P 〈0.01）. Similar changes were not observed in the control group. The immune function of EN group patients was also significantly improved （ P 〈 0.01）. Conclusion The early postoperative enteral nutrition for esophageal and cardiac cancer patients is safe and feasible. It has significant benefits for improving the nutritional status and immune function.