食管癌术后早期肠内营养的临床应用

目的 探讨食管癌术后早期肠内营养的临床疗效.方法 将本院2009年9月～2012年9月住院的食管癌患者98例随机分早期肠内营养组（EEN）和传统肠内营养组（TEN）,每组49例,所有患者均于术后第1、10天测定血红蛋白（Hb）、清蛋白（ALB）、总蛋白（TP）、淋巴细胞计数（TLC）、血清转铁蛋白（TF）水平,观察患者胃肠道功能恢复情况以及各种不良反应.结果 与术前比较,治疗后1d及10 d两组患者Hb、TLC、ALB及TP均不同程度升高,前后差异有统计学意义（P＜0.05）;与TEN组比较,术后10 d EEN组患者Hb、TLC、ALB及TP均显著升高,两组差异有统计学意义（P＜0.05）.EEN组排气时间比TEN组短,差异有统计学意义（t=1 1.057,P＜0.05）;EEN组发生轻度腹胀患者6例,轻度腹泻8例,TEN组患者出现腹胀2例,轻度腹泻3例,两组差异有统计学意义（X2=9.105,P＜0.05）.结论 早期行肠内营养能改变食管癌术后患者的机体营养状态,维护和促进胃肠道功能.

Clinical application of early enteral nutrition for patients with esophageal cancer after operation

Objective To observe the clinical effect of the early enteral nutrition after operation of esophageal cancer. Methods 98 patients of esophageal cancer were divided into early enteral nutrition（EEN） group and traditional enteral nutrition（TEN） group randomly. The hemoglobin（Hb）,lymphocyte count（TLC）,albumin（ALB）,total protein（TP）,transferrin （TF） in postoperative 1,10 day were measured and analyzed between two groups. Clinical adverse reactions and the recovery of gastrointestinal function were observed. Results Compared with preoperation,the level of Hb,TLC,ALB and TP of two groups in 1,10 day after operation were higher,the differences were significant （P〈0.05）,the level of Hb,TLC, ALB,TP in EEN group were higher than TEN group with statistical difference （P〈0.05）. The anus exhaust time of EEN group was earlier than TEN group （t=1 1.057,P〈0.05）;The complication of EEN group were abdominal distension in 6 cases and diarrhea in 8 cases,and in TEN group abdominal distension were found in 2 cases and diarrhea in 3 cases, difference was significant （χ^2=9.105,P〈0.05）. Conclusion The early enteral nutrition can improve the nutritional status, maintain and promote postoperative gastrointestinal function of esohoageal cancer patients.