肠内营养在直肠癌术后急性放射性直肠炎中的作用

目的：评价肠内营养支持对直肠癌术后急性放射性直肠炎的临床疗效。方法：直肠癌根治术后放疗时出现急性放射性直肠炎的患者90例,分为肠内营养（EN）组38例,于入院当天每天供给能全力2000-2500ml。对照组52例,根据患者要求,选择不含脂肪的流质（清水和米汤）、含有低脂肪的流质（鲜奶和肉汤）或半流质饮食。结果：EN组饮食恢复时间为（9.35±2.21）d,明显短于对照组的（12.94±2.95）d（P〈0.01）,患者的精神状态及体力明显强于对照组;血糖、肝肾功能、电解质与对照组比较差异无显著性意义;治疗后体重、前白蛋白、白蛋白及视黄醇结合蛋白等均高于对照组（P〈0.05或0.01）;C反应蛋白显著低于对照组（P〈0.01）。结论：肠内营养对术后急性放射性直肠炎患者中的应用安全,并且疗效好于常规的流质治疗。

Enteral Nutrition of the Patients with Acute Radiation Proctitis after Rectal Cancer Operation

Objective: To explore the clinical effect of enteral nutrition for acute radiation proctitis after rectal cancer operation. Methods: Ninety patients were randomly divided into enteral (EN, n=38) and control (n=52) groups. The two groups were comparable. A series of parameters including the renal and liver functions, serum glucose, electrolytes, nutritional parameters were evaluated before and after the treatment. The complications and resumption of normal food intake were observed and recorded simultaneously. Results: The recovery time of normal food intake was significantly shortened in EN group as compared with control group (P<0.01). There was no evidence of damage of EN to the renal and liver functions. The mental status and physical capacity were better in EN group than in control group and the levels of BW, PA and Alb in EN group were higher than those in control group (P<0.05). Moreover, the level of RBP in EN group was significantly higher than that in control group (P<0.01). The level of CRP in EN group was significantly lower than that in control group (P<0.01). Conclusion: EN is an effective, safe, easy way in acute radiation proctitis after rectal cancer operation.