食管癌术后早期肠内营养对肠功能恢复的影响

目的探讨早期肠内营养支持对食管癌术后小肠运动功能的影响。方法前瞻性入组2011年6．7月间北京大学肿瘤医院胸外一科单一手术组收治的35例食管癌手术患者．按随机数字表法随机分为早期肠内营养组（20例）和早期静脉营养组（15例）。术前进行营养风险筛查．术后24h内对其分别给予整蛋白制剂的肠内营养和肠外营养支持．监测患者肠鸣音恢复的时间及胃肠道症状。结果肠内营养组和静脉营养组术后肠蠕动恢复时间分别为（45．1±20．3）h和（56．7±17．0）h，差异无统计学意义（P=0．082）。肠内营养组4例和静脉营养组3例患者出现恶心、腹胀或腹泻等胃肠道症状，均通过调慢输注速度和增加下床活动次数得以改善．两组胃肠道症状发生率的差异无统计学意义（P=1．000）。结论食管癌术后24h内早期肠内营养安全、可行．不会延缓术后肠功能恢复和增加患者早期胃肠道症状。

Impact of early enteral nutrition on the intestinal motility of patients after esophagectomy

Objective To assess the impact of early enteral nutrition （EN） on the intestinal motility of patients after esophagectomy. Methods Thirty-five consecutive patients undergoing esophagectomy for esophageal cancer by a single surgical team from the Peking University Cancer Hospital from June 2011 to July 2011 were enrolled. Patients were randomly divided into EN group （n= 20） and parenteral nutrition group （control group, n=15） within 24 h after esophagectomy procedure. Bowel sound recovery time was monitored by auscultation, and the gastrointestinal tract symptoms were recorded. Results Bowel sound recovery time was （45.1±20.3） h in the EN group, and was （56.7± 17.0） h in the control group （P=0.082）. Gastrointestinal symptoms such as nausea, abdominal distension, diarrhea occurred in 4 patients in EN group and 3 patients in control group and were alleviated by lowering infusion speed and more off-bed ambulation, and no significant difference was seen between the two groups （P=1.000）. Conclusions Early enteral nutrition in the patients after esophagectomy is safe and feasible. Early enteral nutrition does not delayed bowel function recovery or increase gastrointestinal symptoms.