食管癌术后早期肠内肠外营养的对比研究

目的 探讨食管癌术后早期肠内营养（EN）与肠外营养（PN）对息者营养状况的改善及并发症发生率的影响。方法将106例食管癌根治手术的患者随机分为早期EN组和PN组，手术后第1天开始分别给予营养支持1周，于术前1d、术后8d检测体重、血常规、肝功能，并观察并发症的发生率。结果EN组体重、红细胞数、血红蛋白、白蛋白及转氨酶下降幅度少于PN组，两组比较P〈0．01，差异有统计学意义。EN组息者无吻合口瘘发生，肺部感染发生率为5．7％，胸腔积液发生率为3．8％，无切口愈合不良者；PN组患者吻合口瘘发生率5．7％，肺部感染发生率28．3％，胸腔积液发生率15．1％，切口愈合不良发生率7．6％；丽组比较P〈0．05，差异有统计学意义。结论术后早期EN比PN对食管癌营养状况的改善更好，并发症发生率更低。

Comparative study of postoperative early enteral nutrition and parenteral nutrition in esophageal carcinoma

OBJECTIVE: To investigate the effect of postoperative early enteral nutrition (EN) and parenteral nutrition (PN) on nutritional status and morbidity in esophageal carcinoma. METHODS: One hundred and six patients with esophageal carcinoma were randomly divided into two groups, and received enteral nutrition(n=53) or parenteral nutrition(n=53) continuously for 7 days after operation. The body weight, blood routine test, liver function, and morbidity on postoperative day 8 were compared with those before operation. RESULTS: The body weight, red blood cell count, and the levels of hemoglobin, serum albumin and transaminase decreased less in EN group than those in PN group(P< 0.01). The complication rates of anastomotic fistula, pulmonary infection, pleural effusion and delayed incision healing were 0, 5.7%, 3.8% and 0 in EN group, and 5.7%, 28.3%, 15.1% and 7.6% in PN group. There were significant differences between the two groups(P< 0.05). CONCLUSION: Early postoperative enteral nutrition after esophageal carcinoma surgery can improve nutritional status and reduce complications in comparison with parenteral nutrition.