家庭肠内营养支持对食管癌患者术后体重管理的作用研究

目的：研究足量家庭肠内营养支持对食管癌术后管饲患者的BMI、营养不良发生率、术后体重下降及营养指标的影响，以及评价该方法的效果。方法：对照组：选取我院2018年1月-2018年12月常规术后家庭肠内营养宣教的食管癌管饲患者136例为对照组，干预组：选取我院2019年1月-2019年12月常规术后家庭肠内营养宣教+营养食谱干预的食管癌管饲患者146例作为干预组。研究对象均为家庭肠内营养管饲患者。比较两组患者在营养干预前后体重、BMI、营养不良发生率、体重丢失情况及营养指标的变化。结果：出院时，对照组和干预组在体重、BMI和营养不良发生率的比较差异无统计学意义（P＞0.05），但营养指标中总蛋白、白蛋白、淋巴细胞低于对照组，差异均有统计学意义（P＜0.05）。在营养干预3周后，干预组体重、BMI与对照组相比差异无统计学意义（P＞0.05）；营养不良发生率低于对照组，差异有统计学意义（P＜0.05）；干预组与对照组相比，3周后体重丢失和BMI变化值均降低，差异均有统计学意义（P＜0.001）；营养指标相比，干预组总蛋白、前白蛋白均高于对照组，差异具有统计学意义（P＜0.05），干预组白蛋白略微升高，但差异无统计学意义（P＞0.05）。结论：个体化的肠内营养能够为食管癌术后管饲患者提供足够的营养支持，可以明显预防术后体重丢失，降低术后营养不良发生风险，改善术后营养状况。

The effect of home enteral nutrition support on postoperative weight management of patients with esophageal cancer

Abst1]ract]Objective: To study the effect of adequate home enteral nutrition support on the BMI, incidence of malnutrition, postoperative weight loss and nutritional indicators in patients with tube feeding after esophageal cancer surgery, and evaluate the effect of this method. Methods: Control group: Select 136 patients with esophageal cancer tube feeding in our hospital from January 2018 to December 2018 who were routinely post-operative home enteral nutrition education as the control group. Intervention group: Select our hospital from January 2019 to December 2019, 146 patients with esophageal cancer tube feeding were treated as the intervention group. The subjects were all patients with home enteral nutrition tube feeding. Compare the changes in body weight, BMI, incidence of malnutrition, weight loss and nutritional indicators between the two groups of patients before and after nutrition intervention. Results: There was no statistically significant difference in weight, BMI and incidence of malnutrition between the control group and the intervention group at discharge (P>0.05). However, total protein, albumin, and lymphocytes in nutritional indicators were lower than those of the control group, and the differences were statistically significant (P<0.05). After 3 weeks of nutrition intervention, there was no significant difference in weight and BMI between the intervention group and the control group (P>0.05); the incidence of malnutrition was lower than that of the control group, and the difference was statistically significant (P<0.05); Compared with the control group, the weight loss and BMI change values of the intervention group decreased after 3 weeks, and the difference was statistically significant(P<0.001). Compared with nutritional indicators, the total protein and prealbumin of the intervention group were higher than those of the control group, the difference was statistically significant (P<0.05), and the albumin of the intervention group was slightly increased, but the difference was not statistically significant (P>0.05). Conclusion: Individualized enteral nutrition can provide adequate nutritional support for tube feeding patients after esophageal cancer surgery, which can significantly prevent postoperative weight loss, reduce the risk of postoperative malnutrition, and improve postoperative nutritional status.